Kook Peter H, Wiederkehr D, Makara M, Reusch C E
Klinik für Kleintiermedizin, Vetsuise-Fakultät Universität Zürich, Zürich.
Schweiz Arch Tierheilkd. 2009 Oct;151(10):497-501. doi: 10.1024/0036-7281.151.10.497.
A 13-year-old male intact Golden Retriever was presented for chronic regurgitation and vomitus. The only clinical abnormality was halitosis, a neurological examination was normal. Thoracic radiography revealed a moderately distended, air-filled esophagus and a presumptive diagnosis of idiopathic megaesophagus was made. No other disorder causing abnormal esophageal motor function could be identified. As supportive and anticholinergic therapy failed to improve the dogs condition and ongoing regurgitation worsened, owners opted for euthanasia. Postmortem examination revealed a small (1.5 cm diameter) mass in the terminal esophagus. Microscopically a leio-myoma with mild multifocal mixed-cell esophagitis was diagnosed. This report illustrates how a potentially curable disease such as leiomyoma can clinically mimic acquired idiopathic megaesophagus and emphasizes that additional diagnostic procedures (contrast study, esophagoscopy) can be indicated in individual cases.
一只13岁未绝育的雄性金毛寻回犬因慢性反流和呕吐前来就诊。唯一的临床异常是口臭,神经系统检查正常。胸部X光显示食管中度扩张、充满气体,初步诊断为特发性巨食管症。未发现其他导致食管运动功能异常的疾病。由于支持性治疗和抗胆碱能治疗未能改善犬的病情,且持续反流加重,主人选择实施安乐死。尸检发现食管末端有一个小肿块(直径1.5厘米)。显微镜检查诊断为平滑肌瘤合并轻度多灶性混合细胞食管炎。本报告说明了平滑肌瘤这种潜在可治愈的疾病如何在临床上模仿获得性特发性巨食管症,并强调在个别病例中可能需要进行额外的诊断程序(造影检查、食管镜检查)。