Kurtz Maxime, Paulin Mathieu V, Fournet Alexandre, Decambron Adeline, Fabrès Virginie, Freiche Valérie
Internal Medicine Department, National Veterinary School of Alfort, Maisons-Alfort, France.
Surgery Department, National Veterinary School of Alfort, Maisons-Alfort, France.
JFMS Open Rep. 2021 Mar 25;7(1):2055116921994516. doi: 10.1177/2055116921994516. eCollection 2021 Jan-Jun.
A 7-month-old intact female Maine Coon cat was presented with a 2-month history of regurgitations. Contrast radiographic and endoscopic examinations revealed a diffuse megaoesophagus secondary to a severe lower oesophageal stricture. An epiphrenic diverticulum was noted. Endoscopic balloon dilation was unsuccessful. Gastrotomy was thus performed in order to incise the oesophageal wall radially along the stricture site, and then to dilate the stricture. A diameter of 20 mm was reached. With the aim of preventing stricture recurrence, submucosal injections of triamcinolone acetonide were performed. An 18 Fr oesophagogastric feeding tube was placed and a left gastropexy was performed in order to exert some traction on the gastroesophageal junction, with the aim of reducing the oesophageal diverticulum. Twelve months postoperatively, clinical signs had completely resolved and follow-up radiographs revealed marked improvement of the oesophageal dilatation.
Lower oesophageal strictures should be considered when evaluating regurgitations or megaoesophagus in a kitten. Surgical mucosal radial incision is a therapeutic option in cases of lower oesophageal stricture refractory to balloon dilation, and can lead to a marked improvement of clinical signs and of the oesophagus diameter leading to clinical success.
一只7个月大的未绝育雌性缅因猫因反流2个月前来就诊。造影检查和内镜检查显示,由于严重的食管下段狭窄导致弥漫性巨食管。发现一个膈上憩室。内镜球囊扩张术未成功。因此进行了胃切开术,以便沿狭窄部位径向切开食管壁,然后扩张狭窄。扩张后直径达到20毫米。为防止狭窄复发,进行了曲安奈德黏膜下注射。放置了一根18F的食管胃饲管,并进行了左侧胃固定术,以便对胃食管交界处施加一些牵引力,以减少食管憩室。术后12个月,临床症状完全消失,随访X线片显示食管扩张明显改善。
在评估小猫的反流或巨食管时,应考虑食管下段狭窄。对于球囊扩张难治的食管下段狭窄病例,手术黏膜径向切开是一种治疗选择,可显著改善临床症状和食管直径,从而取得临床成功。