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Esophageal diseases


1. What symptom is most often observed in diseases of the esophagus?
Regurgitation.
2. What is the difference between regurgitation and reflux?
Regurgitation is the passive, retrograde movement of swallowed food to the upper sphincter of the esophagus; as a rule, food does not have time to get into the stomach. Most often, regurgitation occurs as a result of a violation of the motility of the esophagus, obstruction of the esophagus or asynchronous function of the gastroesophageal compound.
Reflux is the leakage of the contents of the stomach and duodenum into the esophagus, not accompanied by belching or vomiting.
3. List the reasons for regurgitation.
1. Megaesophagus (increase in size of the esophagus).
• Idiopathic.
• Secondary:
- myasthenia gravis;
- polyneuropathy;
- systemic lupus erythematosus;
- polymyositis;
- poisoning (lead, thallium);
- hypothyroidism;
- hypoadrenocorticism.
2. Foreign bodies of the esophagus.
3. Stenosis of the esophagus.
• Narrowing the lumen of the esophagus.
• Compression of the esophagus from the outside:
- abscess;
- a tumor in the upper mediastinum;
- chest lymphadenopathy.
4. Anomaly of the vascular plexus.
5. A tumor (primary or metastatic).
6. Granuloma (for example, Spirocerca lupi).
7. Hernia of the esophagus.
8. Diverticulum of the esophagus.
4. What is megaesophagus?
Megaesophagus is a specific syndrome characterized by expansion of the esophagus and a decrease in its peristalsis.
5. What is the most common complication of megaesophagus?
Aspiration pneumonia.
6. Is the expansion of the esophagus on chest x-rays a pathological symptom?
Not. Transient expansion of the esophagus is often due to the following reasons:
Aerophagy;
• animal anxiety;
• respiratory failure (shortness of breath);
• anesthesia;
• vomiting.
7. How is esophageal motility evaluated?
First, a chest x-ray is taken to exclude the presence of a foreign body in the esophagus, enlargement of the esophagus or swelling of the chest. An ideal method for studying the motility of the esophagus is a contrast fluoroscopy of the esophagus with barium. To detect weakened contractility of the esophagus, it is best to mix barium suspension with food.
8. Why is a violation of the motility of the esophagus not detected on esophagograms made using liquid barium suspension?
Esophagograms using liquid barium suspension often show weakened mobility of the esophagus, but this method is mainly used to confirm the contractility of the esophagus. Violation of the motility of the esophagus is best detected by mixing barium suspension with food. The esophagus with impaired contractility is not able to advance the feed and barium mixture towards the stomach.
9. What is myasthenia gravis?
Myasthenia gravis is an acquired or congenital (familial) autoimmune disease caused by the blocking by autoantibodies of nicotine-sensitive acetylcholine receptors of neuromuscular synapses.
10. List the main clinical manifestations of myasthenia gravis.
· Fatigue during physical exertion.
• “Spastic” gait due to damage to the hind limbs.
• Tetraparesis.
• Collapse.
• Tachypnea.
• respiratory failure.
• Drooling.
• Regurgitation.
• Dysphagia.
• Weakness of the facial muscles.
• Decreased eyelid reflex.
11. What test is the method of choice for the diagnosis of myasthenia gravis?
Determination of the titer of antibodies to acetylcholine receptors.
12. What breeds of dogs and at what age are more likely to suffer from myasthenia gravis?
• Most often German Shepherds and Golden Retrievers get sick.
• The onset of the disease occurs in two age periods: 2-4 years and 9-13 years.

13. How to treat myasthenia gravis?
1. Anticholinesterase drugs - neostigmine.
• For injection (prostigmine [Roche]): 0.04 mg / kg intramuscularly every 6 hours,
• For oral use (Mestinon [Roche]): 0.55-1.0 mg / kg every 8-12 hours.
2. Corticosteroids.
14. List the principles of treatment for megaesophagus.
1. Elimination of the cause, if possible.
2. To reduce the likelihood of aspiration of the contents of the esophagus (feed the animal in an upright position, when the upper body is at least 45 ° above the lower body). In this position, the animal should be at least 10 minutes after eating food and at bedtime.
3. An increase in the amount of nutrients supplied with food (if possible, feed the animal 2-4 times a day).
15. What is an alternative way to feed dogs with megaesophagus?
Through the gastrostomy tube.
16. What is the prognosis for a dog with megaesophagus?
Closer to the bad.
17. What are the causes of esophageal stenosis in dogs?
• Esophagitis.
• Reflux of gastric juice during general anesthesia (when tilting the operating table).
• Ingestion of strong acid or alkali.
• Foreign bodies of the esophagus.
• Thermal burns.
• Hair balls (usually in cats).
18. How is esophageal stenosis diagnosed?
The diagnosis is based on the results of esophagography with barium and endoscopic examination of the esophagus.
19. List the methods of treatment for stenosis and evaluate the magnitude of the positive outcomes of treatment.
• Surgical intervention (esophagotomy, esophagoplasty using transplant, resection with anastomosis): <50 / o successful operations.
• Gulping of the esophagus: in 50-70% of cases, a positive effect.
• Dilatation of the esophagus using a balloon catheter: positive effect in more than 50-70% of cases (method of choice; it is better to carry out under the control of fluoroscopy).
20. In which sections of the esophagus are most often foreign bodies?
• At the level of entry of the esophagus into the chest.
• At the base of the heart.
• At the level of the esophageal opening of the diaphragm.
21. How to treat dogs with foreign bodies of the esophagus?
The presence of a foreign body in the esophagus is considered an emergency. The following is the recommended sequence of medical interventions.
1. Usually, it is possible to remove a foreign body from the esophagus using an endoscope, either to remove it or to carefully push it into the stomach. If it is a bone, then it is better to push it into the stomach. Performing a gastrotomy to remove bone from the stomach, as a rule, is not required, but you need to do a series of radiographs to make sure the bone is digested or moved along the intestines.
2. If it is impossible to remove a foreign body, an esophagoscope shows surgical intervention.
3. Inspect the mucous membrane of the esophagus to detect bleeding damage, wounds or perforations.
4. Do not feed or drink the animal for 24–48 hours; provide intravenous infusion of crystalloid solutions, parenteral administration of antibiotics.
22. What medications are used in the treatment of esophageal reflux?
• Metoclopramide (raglan) increases the tone of the gastroesophageal sphincter and reduces the reflux of the contents of the stomach into the esophagus.
• H2 receptor blockers (eg, cimetidine or ranitidine) lower the acidity of gastric contents.
• Sucralfate suspension is an aluminum salt that selectively binds to the damaged mucous membrane of the esophagus and stomach, creating an effective protective barrier against aggressive components of the stomach contents such as hydrochloric acid, pepsin and bile acids, which play a major role in the pathogenesis of reflux esophagitis.
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Esophageal diseases

  1. Esophageal diseases
    General reasoning The esophagus sometimes has various disorders of nature, weakening its [ability] to perform its action, that is, swallowing. All sorts of diseases of the instrument and diseases of complicity occur in it, in which tumors are formed hot, cold and hard, from diseases of the instrument blockages most often occur in it; [they occur] either due to outside pressure,
  2. Barrett's esophagus, adenocarcinoma of the esophagus
    There is no reliable data on the incidence of adenocarcinoma with Barrett's esophagus, but it is proved that the risk of the disease increases in this case by 20-40 times. Presumably, the mechanisms of carcinogenesis are similar to those in colon cancer - chronic damage to the epithelium and cell proliferation lead to genetic rearrangements and, ultimately, to the neoplastic process.
  3. Esophageal stricture
    - narrowing of the esophagus associated with congenital or acquired factors Classification of cicatricial narrowing of the esophagus (G. L. Ratner, VI Belokonev, 1982) By etiology: burns with acids, alkalis, other burns By the time of obstruction: early (3-4 weeks), late (later than 1 month) According to the mechanism of development and clinical manifestations: A. Functional obstruction of the esophagus 1.
  4. Esophagus DIVERTICULES
    - blindly ending process or protrusion of the organ. LINKER DIVERTICULES - localized along the back wall of the pharynx and esophagus. Classification of diverticulums of the esophagus, diverticulitis (according to Yusbasic, 1961) By localization: 1. Pharyngo-esophagic (Tsenker), 2. Bifurcation. 3. Epiphrenal. Largest diverticulum: Stage I - protrusion of the mucous membrane of the esophagus
  5. Esophagus (problems)
    The esophagus is the part of the digestive tract between the larynx and the stomach. The esophagus passes through the neck, chest and diaphragm. The following diseases are characteristic of it; DIVERTICULITIS, HERNIA, OR CONGENITAL DEFECTS. Pain in the esophagus can be caused by a foreign object in it or the sensation that a foreign object is in it. Since the esophagus is the beginning of the digestive tract,
  6. ESOPHAGUS
    The esophagus (esophagus) is a cylindrical tube 25-30 cm long that connects the pharynx to the stomach. It begins at the level of the VI cervical vertebra, passes through the chest cavity, diaphragm and flows into the stomach to the left of the X-XI thoracic vertebra. There are three parts of the esophagus: cervical, thoracic and abdominal. The cervical part is located between the trachea and the spine at the level of the VI cervical and up to the II thoracic
  7. Esophagus Features
    The esophagus in young children has a fusiform shape, it is narrow and short. In a newborn, its length is only 10 cm, in children in 1 year of life - 12 cm, in 10 years - 18 cm. Its width, respectively, is 7 years old - 8 mm, at 12 years old - 15 mm. There are no glands on the mucous membrane of the esophagus. It has thin walls, poor development of muscle and elastic tissues, and is well supplied with blood.
  8. Benign Tumors of the Esophagus
    Classification 1. Solitary myomyomas. - acquired neoplasia. 2. Nodose-multiple myomas. 3. Common leiomyomatosis 4. Polyps: adenomas, lipomas, etc. 5. Cysts. Diagnostic criteria Dysphagia, dyspepsia; pain along the esophagus. Examples of diagnosis: 1. Solitary myoma of the esophagus. 2. Knotty-multiple esophageal myomas. 3.
  9. Peptic ulcer of the esophagus
    - A variety of esophagitis, often combined with cholelithiasis and gastroduodenal ulceration, accompanied by cardia insufficiency, due to the cup of the entire hernia of the esophageal opening of the diaphragm. Diagnostic criteria 1) Pain behind the sternum, worse after eating, when swallowing, in a prone position; 2) dysphagia; 3) heartburn, belching, regurgitation of gastric contents; 4) complications:
  10. Esophagus
    The normal esophagus is a hollow, well-stretched muscle tube extending from level VI of the cervical vertebra to level XI or XII of the thoracic vertebrae. These levels correspond to the transition of the pharynx to the esophagus and esophageal-gastric connection. In newborns, the esophagus has a length of 10-12 cm, and in adults - 23-25 ​​cm. There are three anatomical narrowing of the esophagus, which lasts for
  11. Esophageal injury
    The most common cause of esophageal injury is foreign bodies, as well as damage caused by instruments during esophagoscopy for various purposes, including removal of a foreign body. Instrumental damage to the esophagus is also described with its bougieurage, cardiodilation, intubation and insertion of the probe. Other causes, such as compression and injury to the neck and chest
  12. Clinical anatomy and topography of the esophagus
    The esophagus (oesophagus) is a continuation of the pharynx from the level of the lower edge of the cricoid cartilage (VI cervical vertebra). The esophagus passes into the stomach at the level of the 11th thoracic vertebra. The esophagus is a tube flattened in the anteroposterior direction 24-25 cm long. Three sections are distinguished in the esophagus: 1. Cervical. 2. Thoracic. 3. The abdominal. In the cervical and early thoracic
  13. Blockage of the esophagus
    Most often found in kittens, which during the game can swallow plastic or rubber toys or their pieces. In adult cats, blockage of the esophagus is extremely rare, usually due to excessively greedy eating of food. Symptoms: the first signs of an esophageal blockage are restless behavior, the cat twists its head, twitches, scratches its mouth, coughs, can be observed
  14. Esophageal atresia
    DEFINITION Atresia of the esophagus is a malformation in which the proximal and distal ends of the esophagus do not communicate with each other. CODE ICD-Q39.0 Atresia of the esophagus without fistula. Q39.1 Atresia of esophagus with tracheoesophageal fistula. Q39.2 Congenital tracheoesophageal fistula without atresia EPIDEMIOLOGY Among newborns with esophageal atresia, about 30% are premature. CLASSIFICATION Accepted
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