Surgery, Anesthesiology and Radiology Department, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt.
Anatomy and Embryology Department, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt.
PLoS One. 2020 Jun 2;15(6):e0233983. doi: 10.1371/journal.pone.0233983. eCollection 2020.
Anatomical feline models can aid in understanding the relationships between clinical findings and anatomical features and the course of foreign bodies passing through the oesophagus. This study has two goals 1) to assess feline oesophageal foreign bodies in feline patients using physical, radiologic and endoscopic examination and, how their location influences treatment plans and complications. 2) How the anatomical sharp angle of the oesophagus contribute to foreign body lodgement. Thirty-five cats were enrolled in this study; 30 of them were clinically ill, and five cats were used for anatomical study.
Cats with clinical signs underwent complete clinical and radiologic examination. Endoscopy was performed in only five cases. The site with the highest occurrence of foreign body lodgement was the oesophageal entrance, caudal to the pharynx (63.3%), followed by the thoracic inlet (26.7%) and the mid-cervical region of the oesophagus (10%). Two types of foreign bodies were identified: sewing needles (25/30) and bone (5/30). Radiography was able to identify the location and nature of the foreign body in all 30 affected cats. Therapeutic regimens were applied according to the nature and location of the foreign body and any associated complications. Removal of the foreign body was achieved using Rochester pean artery forceps in 17/30 cases, using full surgical intervention in 8/30 cases, and during endoscopy in 5/30 cases.
The results suggest that the location of the foreign body is strongly related to combination of consumed foreign body type and anatomic features of the cat oesophagus. The feline oesophagus has a variety of sharp angles that facilitate the entrapment of rigid linear and angular foreign bodies. Radiographic imaging remains the most frequently used diagnostic modality for determining the lodgement site and nature of radiopaque foreign bodies. Over all complication rate was low (6/30).
解剖学猫模型可以帮助理解临床发现与解剖特征之间的关系,以及异物通过食道的过程。本研究有两个目标:1)使用物理、放射学和内窥镜检查评估猫食道异物,并评估其位置如何影响治疗计划和并发症。2)食道解剖锐角如何导致异物嵌顿。本研究纳入 35 只猫;其中 30 只为临床病例,5 只为解剖研究。
有临床症状的猫进行了完整的临床和放射学检查。仅对 5 例进行了内窥镜检查。异物最常滞留的部位是食道入口,位于咽后(63.3%),其次是胸入口(26.7%)和食道中颈部(10%)。两种类型的异物被识别:缝针(25/30)和骨头(5/30)。放射学检查能够识别 30 只受影响猫中异物的位置和性质。根据异物的性质和位置以及任何相关并发症,应用治疗方案。使用罗切斯特动脉夹取出异物 17/30 例,通过全手术干预取出异物 8/30 例,通过内窥镜取出异物 5/30 例。
研究结果表明,异物的位置与所摄入的异物类型和猫食道的解剖特征密切相关。猫食道有多种锐角,有利于刚性线性和角形异物的嵌顿。放射影像学仍然是确定异物滞留部位和不透射线异物性质的最常用诊断方式。总体并发症发生率较低(6/30)。