Changes

Hiatal Hernia (view source)

Revision as of 17:49, 7 August 2009

469 bytes removed , 17:49, 7 August 2009

no edit summary

Line 37: Line 37:

==Treatment==

−

Medical therapy should be attempted first:

+

'''Medical therapy''' should be attempted first:

−

*

+

*oral sucralfate

−

~~The suspected cause (ie.Oesphagitis)should be corrected first.~~

+

*gastric acid secretory inhibitors (cimetidine, ranitidine, omeprazole)

−

~~Oral feedings should be withdrawn in patients with severe stricture or oesophagitis. An oesophagostomy tube may be placed in these cases to provide nutritional support.~~

+

*increase tone of caudal oesophageal sphincter (metoclopramide)

−

~~Medical therapies:~~

−

*Oral sucralfate

−

*~~Gastric~~ acid secretory inhibitors (cimetidine, ranitidine, omeprazole)

−

*~~Anti-inflammatory doses~~ of ~~corticosteroids~~ (~~prednisolone~~) ~~to prevent fibrosis and re-stricture.~~

−

~~Surgical therapies:~~

−

*Dilation/widening of the stricture by ballooning or bougienage.

−

*Surgical resection is not recommended because iatrogenic strictures at the anastomotic site are possible.

+

'''Surgical therapy''' is usually attempted with congenital cases :

+

*laryngeal surgery if laryngeal paralysis has contributed to the hernia.

+

*diaphragmatic crural apposition, oesophagopexy and gastropexy.

+

*tube gastropexy with cases with severe oesophagitis or ulceration.

==Prognosis==

−

~~The shorter the length of oesophagus involved and the quicker the corrective procedure~~ is ~~performed the better the prognosis~~.

+

Prognosis is good after surgical repair or aggressive medical management.

−

~~Animals with large, mature strictures and those with continued oesophagitis have a guarded prognosis. Long term gastrostomy tubes may be required in some cases.~~

−

==References==

*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''

−

*Merck & Co (2008) '''The Merck Veterinary Manual'''

*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.

Mfield

561

edits