Oesophageal Diverticula
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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