Difference between revisions of "Oesophageal Diverticula"
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*No important breed or sex predisposition | *No important breed or sex predisposition | ||
==Description== | ==Description== | ||
| − | A circumscribed sacculation of the oesophageal wall. These can be divided into congenital or acquired. Congenital diverticula are due to a herniation of the mucosa through a muscularis defect. Acquired diverticula can be subdivided into: | + | A circumscribed sacculation of the oesophageal wall. These can be divided into '''congenital''' or '''acquired'''. Congenital diverticula are due to a herniation of the mucosa through a muscularis defect. Acquired diverticula can be subdivided into: |
#'''Traction forms''' consists of all the oesophageal layers and results from peri-oesophageal inflammation and fibrosis and develop mainly in the cranial and mid-oesophageal body. Sacculations are created by adhesions to adjacent tissues. | #'''Traction forms''' consists of all the oesophageal layers and results from peri-oesophageal inflammation and fibrosis and develop mainly in the cranial and mid-oesophageal body. Sacculations are created by adhesions to adjacent tissues. | ||
#'''Pulsion forms''' includes the epithelium and connective tissue and results from: | #'''Pulsion forms''' includes the epithelium and connective tissue and results from: | ||
| Line 34: | Line 34: | ||
'''Endoscopy''': will confirm the diagnosis | '''Endoscopy''': will confirm the diagnosis | ||
==Treatment== | ==Treatment== | ||
| − | *Small diverticula - managed by feeding bland soft or liquid diets. | + | *'''Small diverticula''' - managed by feeding bland soft or liquid diets. |
| − | *Small pulsion diverticula - should be surgically corrected as food impaction may enlarge the diverticula. | + | *'''Small pulsion diverticula''' - should be surgically corrected as food impaction may enlarge the diverticula. |
| − | *Larger diverticula - require surgical excision and reconstruction of the wall of the oesophagus. | + | *'''Larger diverticula''' - require surgical excision and reconstruction of the wall of the oesophagus. |
==Prognosis== | ==Prognosis== | ||
Fair to guarded due to post-op complications of oesophageal hypomotility and oesophageal stricture formation. | Fair to guarded due to post-op complications of oesophageal hypomotility and oesophageal stricture formation. | ||
==References== | ==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''' | ||
Revision as of 11:42, 10 August 2009
 |
This article is still under construction. |
Typical Signalment
- Rare in small animals
- More common in dogs than cats
- No important breed or sex predisposition
Description
A circumscribed sacculation of the oesophageal wall. These can be divided into congenital or acquired. Congenital diverticula are due to a herniation of the mucosa through a muscularis defect. Acquired diverticula can be subdivided into:
- Traction forms consists of all the oesophageal layers and results from peri-oesophageal inflammation and fibrosis and develop mainly in the cranial and mid-oesophageal body. Sacculations are created by adhesions to adjacent tissues.
- Pulsion forms includes the epithelium and connective tissue and results from:
- an increase in intraluminal oesophageal pressure
- abnormal local oesophageal motiltiy
- deep oesophageal inflammation
- a stenosis interupting normal peristalsis
- vascular ring abnormalities
- lodged foreign bodies
Diagnosis
Clinical Signs
usually result from food/fluid impaction in the sacculated area and can present as:
- regurgitation
- odynophagia
- retching
- postprandial dyspnoea
- anorexia
- sepsis if the diverticulum becomes perforated
- may be subclinical if small
Laboratory Tests
Normal
Diagnostic Imaging
Survey radiography: may show an air/soft tissue density next to or involving the oesophagus
Contrast radiography: will show focal dilation or a partial or complete filling of contrast media in the lumen of the oesophagus.
Endoscopy: will confirm the diagnosis
Treatment
- Small diverticula - managed by feeding bland soft or liquid diets.
- Small pulsion diverticula - should be surgically corrected as food impaction may enlarge the diverticula.
- Larger diverticula - require surgical excision and reconstruction of the wall of the oesophagus.
Prognosis
Fair to guarded due to post-op complications of oesophageal hypomotility and oesophageal stricture formation.
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