Surgical management of a cervical esophageal diverticulum in and long-term outcome for a five-month-old cat.

CASE DESCRIPTION: A 5-month-old domestic shorthair cat was presented for recurrent regurgitation and hypersalivation after eating, which had been evident since adoption 2 months earlier. CLINICAL FINDINGS: Physical examination was unremarkable. Plain thoracic radiography, positive contrast esophagography, endoscopy, CT, electromyography, and blood analysis were performed. A caudal cervical esophageal diverticulum, likely congenital, was diagnosed. TREATMENT AND OUTCOME: A diverticulectomy was performed with a surgical stapler while an endoscope was in the esophageal lumen. No intra- or postoperative complications were reported. Postoperative and short-term outcomes were excellent, with resolution of clinical signs and no endoscopic esophageal abnormality 3 months after surgery. The cat remained without clinical signs 8 months after surgery. CLINICAL RELEVANCE: An esophageal diverticulum in a cat is rare. The cat of this report had a good outcome following surgical management of a cervical esophageal diverticulum. Surgery is worth considering for similarly affected cats, but additional cases are required to confirm the benefit of surgery versus conservative management.

Surgical treatment of persistent right aortic arch with combined ligamentum arteriosum transection and esophageal diverticulum resection in three dogs.

OBJECTIVE: To describe the treatment of persistent right aortic arch (PRAA) in dogs with combined ligamentum arteriosum (LA) transection and esophageal diverticulum resection. ANIMALS: Three client owned dogs. STUDY DESIGN: Short case series. METHODS: Medical records were reviewed for clinical signs, diagnostic procedures, surgical treatment, post-operative therapies including medications and feeding regime, outcomes, and follow-up imaging. RESULTS: Esophageal resection was performed using a thoracoabdominal (TA) stapler with suture overlay. All dogs recovered well from surgery and did not experience any peri- or post-operative complications. The last follow-up was performed between 64 and 1004 days post-operatively. In all cases, regurgitation resolved and did not recur in any dogs. No dogs required medical therapy or dietary modifications. In two cases, follow-up imaging was performed that revealed marked improvement of esophageal dilation. CONCLUSION: Resection of esophageal diverticulum secondary to PRAA utilizing a TA stapler with suture overlay was technically feasible and did not seem associated with early or late complications.

Intrathoracic pulsion diverticulum in a horse.

This is a report of a 12-year-old Swedish Warmblood gelding with a ruptured esophageal pulsion diverticulum associated with atypical clinical signs of colic and septic peritonitis on presentation. The location of this diverticulum at the hiatus was unique and was most likely responsible for the unusual presentation of this horse.

Characteristics of esophageal diverticula using computed tomography and three-dimensional reconstruction in a Maltese dog.

A 7-year-old intact female Maltese dog was referred with ptyalism and intermittent vomiting but no regurgitation for over 1 month. Survey radiographs including a contrast study revealed a large circular dilated cavity from the carina to the diaphragm. Additionally, multi-detector computed tomography and three-dimensional reconstruction were performed. These images revealed large idiopathic distal esophageal diverticula. This case report represents the first report using multi-detector computed tomography and three-dimensional reconstruction for evaluation of esophageal diverticula in a dog.

A retrospective and prospective study of megaesophagus in the parma wallaby (Macropus parma) at the San Diego Zoo, California, USA.

At the San Diego Zoo (California, USA), 22 cases of megaesophagus were diagnosed in the parma wallaby (Macropus parma); a prevalence of 21.1%. Parma wallabies often have no clinical signs until severe and chronic dilation of the esophagus is present. Clinical signs of advanced disease include weight loss, swelling of the cervical region, regurgitation without reswallowing of ingesta, short flight distance, depression, collapse, dyspnea, and sudden death. Retrospective and prospective studies at the San Diego Zoo and a multi-institutional survey in the United States were used to try to determine the cause of megaesophagus. The retrospective study did not identify an etiology. The prospective study revealed megaesophagus and severely delayed esophageal transit time in eight of eight animals. Myasthenia gravis, lead toxicosis, toxoplasmosis, and thyroid disease were eliminated as possible causes. Of 286 living and dead parma wallabies surveyed at other institutions, three cases of esophageal diverticulum and one case of megaesophagus were reported. The cause of megaesophagus in parma wallabies was not determined.

Canine bronchoesophageal fistulas: case report and literature review.

A bronchoesophageal fistula (BEF) is defined as a communication between the esophagus and one or more bronchi. BEFs are commonly associated with esophageal diverticula, which are circumscribed outpouchings of the esophageal wall. This article presents the report of a case seen at Louisiana State University Veterinary Teaching Hospital and Clinics in 2006 and reviews the pathogenesis, diagnosis, and treatment of esophageal diverticula and BEFs. The BEF in the case presented was of a very rare form, involving only the accessory lung lobe bronchus.

Esophageal diverticulum associated with a trichobezoar in a cat.

A 9-year-old, castrated male, domestic longhaired cat was evaluated for persistent regurgitation over the previous month. The cat had presented 9 months earlier and was diagnosed with esophageal obstruction secondary to a trichobezoar. The trichobezoar had been removed endoscopically, and the cat was subsequently fed a canned prescription diet. The owners noted only infrequent regurgitation over the following 9 months. After signs recurred, contrast radiography with fluoroscopy revealed an esophageal diverticulum at the thoracic inlet, with an ovoid filling defect. Decreased esophageal motility was noted distal to the diverticulum. Esophagoscopy confirmed the presence of a trichobezoar within an esophageal diverticulum. Following removal of the trichobezoar and therapy to prevent trichobezoar formation, the cat did well for 2 months until it died suddenly with signs of hyperventilation and open-mouth breathing.

Esophageal diverticula in Parma wallabies (Macropus parma).

Four adult, wild caught Parma wallabies (Macropus parma) presented with intermittent, postprandial, midcervical swellings. Esophageal diverticula were discovered in the four animals. One of two wallabies was managed successfully with surgery. A third animal died of other causes. The fourth animal died with possible complications from the diverticulum. This is the first published report of esophageal diverticula in macropods.

Divertículo esofágico en unpastor alemán: reporte de caso / Esophageal diverticulum in a dog: a case report

Un paciente canino de raza Pastor alemán se trató satisfactoriamente por una gastroenteritis infecciosa, sin embargo se detectó que el perro regurgitaba con frecuencia. En el esofagograma con bario se observó una gran dilatación esofágica en el tercio proximal del esófago torácico y en la esofagoscopia se confirmó la presencia de un divertículo esofágico. El tratamiento quirúrgico incluyó la toracotomía lateral con resección quirúrgica del divertículo, colocación de un tubo de drenaje torácico usando una válvula de Heimlich. También fue colocado un tubo de gastrostomía para alimentación enteral. El paciente se recuperó satisfactoriamente de la cirugía, sin presentar ninguna complicación. Los divertículos esofágicos son de presentación poco frecuente en los perros y su ruptura puede llevar a condiciones graves como mediastinitis y la muerte del paciente. La resección quirúrgica es el tratamiento de elección sólo en los divertículos que manifiesten síntomas clínicos que alteren la calidad de vida los pacientes.

A German Shepard dog was attended presenting an infectious gastroenteritis. Once the dog responded to treatment, it was noticed that the patient regurgitated frequently. In the barium esophagogram it was detected a big esophageal dilatation in the proximal third of the thoracic esophagus, and the upper endoscopy confirmed an esophageal diverticulum. The surgical intervention included a lateral thoracotomy with esophageal diverticulum resection, thoracic tube drainage with a Heimlich valve, and a gastrostomy tube placement for enteral nutrition. The patient recovered satisfactory without any complication. Esophageal diverticulum is infrequent in dogs and its rupture can lead to critical conditions as mediastinitis and death. Surgical resection is essential in the treatment of esophageal diverticulum in cases were clinical symptoms are important.

Esophageal diverticulum associated with Aerococcus viridans infection in a loggerhead sea turtle (Caretta caretta).

A juvenile loggerhead sea turtle (Caretta caretta) stranded in Gran Canaria, Spain was necropsied. The turtle was underweight, had sunken eyes, and small amounts of crude oil were in the oral cavity. The most significant lesion was a large esophageal diverticulum at the junction of the esophagus and stomach. The diverticulum was full of gas and green mucoid fluid and a diffuse thick yellow fibrinonecrotic membrane covered the mucosa. The lumen of the diverticulum also contained moderate numbers of cephalopods, crustaceans, and anthropogenic debris including crude oil balls, plastics, and fishing lines. Histologically there was a severe diffuse fibrinonecrotic esophagitis. Aerococcus viridans was isolated from the diverticulum. This is the first report of an esophageal diverticulum in a sea turtle. Although A. viridans is a known pathogen of lobsters and fishes, there are no reports of A. viridans infection in sea turtles.

Surgical repair of an intrathoracic esophageal pulsion diverticulum in a horse.

An intrathoracic esophageal pulsion diverticulum causing repeated episodes of esophageal obstruction in a Morgan weanling colt was diagnosed by endoscopy, positive contrast radiography, and pleuroscopy. Surgical excision of the diverticulum alleviated clinical signs, and the horse was able to resume a normal diet by day 6. After 9 months the colt remains asymptomatic.

Surgical correction of a traumatic esophageal diverticulum in a horse.

A nine-year-old gelding was presented to the Auburn University Large Animal Clinic with discharge of saliva and food material from both nostrils. A diagnosis of esophageal diverticulum was made; treatment is described.

Esophageal disorders in 61 horses. Results of nonsurgical and surgical management.

Obstructive esophageal disorders in 61 horses included feed or foreign body impaction (27 horses), strictures (18 horses), perforations (11 horses), and diverticula (5 horses). Horses with feed impaction were treated nonsurgically (25 horses) or by esophagotomy (2 horses). Survival to discharge was 78%, and 37% of these had persistent chronic obstruction at home. Long-term survival was 52%. Long-term survival of nine horses treated nonsurgically for esophageal strictures was 22%; for nine horses treated surgically it was 44%. Long-term survival of horses treated nonsurgically was significantly better in acute than chronic strictures. Surgical repair of esophageal mural strictures was more successful than repair of annular or mucosal strictures. One third of the horses with strictures were foals. Long-term survival for horses with strictures was 33%. Long-term survival was higher for the horses with perforations managed surgically (2 of 4) than nonsurgically (0 of 7). Long-term survival for this group was 18%. One esophageal diverticulum was managed nonsurgically, and four were treated surgically; all horses survived long term. Complications of obstructive esophageal disorders included aspiration pneumonia, chronic obstruction, esophageal mucosal ulceration, postoperative infection, pleuritis, laminitis, laryngeal paralysis, and Horner's syndrome.

Surgical diseases of the esophagus.

The diagnosis and management of surgical diseases of the esophagus are discussed. Esophageal foreign bodies, strictures, esophagobronchial fistulas, diverticula, gastroesophageal intussusception, hiatal hernias, and megaesophagus are included in the discussion.

Esophageal healing in the pony: comparison of sutured vs nonsutured esophagotomy.

Esophageal healing was evaluated in 10 ponies after sutured and nonsutured cervical esophagotomy techniques. Mucosal healing occurred significantly (P less than 0.005) faster after sutured esophagotomies (x = 7.5 days after surgery) than after nonsutured esophagotomies (x = 25.6 days after surgery), based on endoscopic and clinical evaluations. Although endoscopy was an accurate assessment of the return of normal passage of a food bolus through the esophagus, 4 of 10 ponies had radiographic evidence of a sinus tract after the mucosa was considered healed, based on endoscopic and clinical examinations. The surgical skin wound also healed significantly sooner after sutured esophagotomies (x = 10 days) than after nonsutured esophagotomies (x = 33.4 days). A traction diverticulum developed in all ponies with nonsutured esophagotomies, but occurred in only 1 pony with sutured esophagotomy. Minor complications were seen more frequently with sutured esophagotomy than with a nonsutured esophagotomy, but were resolved with local therapy. Saliva appeared to inhibit wound healing. All ponies were fed through esophagostomy tubes until the mucosa at the esophagotomy site was considered healed. Except for 1 sutured esophagotomy that dehisced, sutured esophagotomy was superior to nonsutured esophagotomy, because earlier establishment of a mucosal seal resulted in more rapid healing and reduced nursing care.

An oesophageal diverticulum in a dog.

An 11-month-old male Miniature Poodle was found to regurgitate small volumes of fluid and food particles due to a diverticulum in the thoracic oesophagus. The diverticulum was removed surgically. Histologically the wall contained extensive scar tissue. Longterm recovery was uneventful and 5 months after surgery the dog is in good health