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Hiatal Hernia (view source)

Revision as of 17:49, 7 August 2009

469 bytes removed ,  17:49, 7 August 2009
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==Treatment==
 
==Treatment==
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Medical therapy should be attempted first:
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'''Medical therapy''' should be attempted first:
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*
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*oral sucralfate
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The suspected cause (ie.Oesphagitis)should be corrected first.
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*gastric acid secretory inhibitors (cimetidine, ranitidine, omeprazole)
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Oral feedings should be withdrawn in patients with severe stricture or oesophagitis.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.
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*increase tone of caudal oesophageal sphincter (metoclopramide)
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Medical therapies:
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*Oral sucralfate
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*Gastric acid secretory inhibitors (cimetidine, ranitidine, omeprazole)
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*Anti-inflammatory doses of corticosteroids (prednisolone) to prevent fibrosis and re-stricture.
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Surgical therapies:
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*Dilation/widening of the stricture by ballooning or bougienage.
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*Surgical resection is not recommended because iatrogenic strictures at the anastomotic site are possible.
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'''Surgical therapy''' is usually attempted with congenital cases :
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*laryngeal surgery if laryngeal paralysis has contributed to the hernia.
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*diaphragmatic crural apposition, oesophagopexy and gastropexy.
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*tube gastropexy with cases with severe oesophagitis or ulceration.
    
==Prognosis==
 
==Prognosis==
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The shorter the length of oesophagus involved and the quicker the corrective procedure is performed the better the prognosis.
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Prognosis is good after surgical repair or aggressive medical management.
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Animals with large, mature strictures and those with continued oesophagitis have a guarded prognosis. Long term gastrostomy tubes may be required in some cases.
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==References==
 
==References==
    
*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''
 
*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''
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*Merck & Co (2008) '''The Merck Veterinary Manual'''
      
*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.
 
*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.
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