ISSN 2398-2969      

Esophagus: stricture

icanis

Introduction

  • Cause:
    • Post-anesthetic stricture (most common).
    • Traumatic foreign bodies.
    • Ingestion of caustic materials (rare)/medication, eg doxycycline.
    • Accidental trauma.
  • Most common sequel to esophagitis.
  • Signs: dysphagia, salivation, pain on swallowing, regurgitation - developing over several weeks.
  • Site: thoracic inlet and between base of heart - cardia.
  • Important sequelae: aspiration of regurgitated ingesta, megaesophagus cranial to stricture.
  • Treatment: dilation by serial bougienage or balloon dilation.
  • Prognosis: guarded to poor, frequently recur.

Pathogenesis

Etiology

  • Acquired at time of general anesthesia (most common).
  • Trauma due to foreign bodies Esophagus: foreign body.
  • Ingestion of caustic materials (rare)/medication, eg doxycycline, benzalkonium chloride.
  • Subsequent upon esophageal surgery.
  • Accidental trauma.
  • Associated with persistent right aortic arch Vascular ring anomalies.
  • Occasionally neoplasia.
  • Idiopathic.

Specific

  • Prior general anesthesia for abdominal surgery.

Pathophysiology

  • Post-anesthetic stricture (most common) - erosive reflux esophagitis due to pooling of acidic gastric contents following relaxation of gastro-esophageal sphincter during general anesthetic.
  • Clinical signs develop within 1-6 weeks of anesthetic episode/inciting cause.
  • Initially fluids tolerated - eventually these regurgitated also.
  • Can be anywhere along thoracic esophagus.
  • Aspiration of regurgitated ingesta and development of megesophagus cranial to stricture - important sequelae.

Timecourse

  • Clinical signs develop within 1-6 weeks of inciting cause.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Leib M S, Dinnel H, Ward DL et al (2001) Endoscopic balloon dilation of benign esophageal strictures in dogs and cats. JVIM 15 (6), 547-552 PubMed.
  • Weyrauch E A & Willard M D (1998) Esophagitis and benign esophageal strictures. Comp Cont Ed Prac Vet 20 (2), 203-212 VetMedResource.
  • Harai B H et al (1995) Endoscopically guided balloon dilation of benign structures in six cats and seven dogs. J Vet Intern Med 9 (5), 332-335 WileyOnlineLibrary.
  • Willard M D, Dellers E K & Fossum T W (1994) Iatrogenic tears associated with ballooning of esophageal strictures. JAAHA 30 (5), 431-435 VetMedResource.
  • Hurley et al (1993) Left aortic and right liganatum anteriosum causing esophageal obstruction in a dog. JAVMA 203 (3), 410-412 PubMed.
  • Johnson K A et al (1992) Correction of cervical esophageal stricture in a dog by creation of a traction diverticulum. JAVMA 201 (7), 1045-1048 PubMed.
  • Flanders J A (1989) Problems and complications associated with esophageal surgery. Prob Vet Med 1 (2), 183-194 PubMed.
  • Burk R L, Zawie D A & Garvey M S (1987) Balloon catheter dilation of intramural esophageal strictures in the dog and cat - a description of the procedure and report of 6 cases. Semin Vet Med Surg 2 (4), 241-247 VetMedResource.
  • Hardie et al (1986) Baller dilatation for treatment of esophageal stricture - a case report. JAAHA 23, 547-550.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code