ISSN 2398-2977      

Esophagus: stricture

pequis

Introduction

  • Narrowing of the esophageal lumen by stricture, oftentimes from an annular lesion and in the proximal third of cervical esophagus.
  • Cause: congenital; a result of cicatrization of circumferential ulceration following esophageal trauma/foreign body Esophagus: trauma; leakage of saliva after surgery; external compression. 
  • Signs: recurrent choke Esophagus: impaction; drooling +/- coughing following ingestion of solid food; nasal regurgitation; weight loss Weight loss: overview; poor growth.
  • Diagnosis: site may be visible externally; endoscopy Gastrointestinal endoscopy; fluoroscopy; radiography (positive and negative contrast Radiography: contrast media).
  • Treatment: lumenal bouginage using endotracheal tube or esophageal dilator; esophageal surgery: should be referred to specialist surgeon.
  • Prognosis: good if only mucosal stricture; poor if deeper layers of esophageal wall are involved.

Pathogenesis

Etiology

  • Esophageal impaction (choke) Esophagus: impaction.
  • Oral administration/ingestion of corrosive substances/medicines.
  • Trauma to neck/esophagus.
  • Congenital.
  • A variety of strictures are classified as follows:
    • Grade 1: congenital web stricture (many foals have these 'normally' and they disrupt naturally as the consistency of the food increases).
    • Grade 2: stricture involving mucosa and submucosa (esophageal webs or rings).
    • Grade 3: stricture involving mucosa, submucosa and muscular layer(s) (mural strictures).
    • Grade 4: full thickness stricture - usually a result of cicatrization of circumferential ulceration following esophageal trauma/foreign body (annular stenosis).

Predisposing factors

Specific

Pathophysiology

  • Most commonly caused by esophageal impactions Esophagus: impaction → pressure necrosis → circumferential erosion or ulceration of esophageal mucosa → cicatrization of esophageal wall Esophagus: stricture 03 - pathology.

Timecourse

  • Maximal stricture usually occurs within 30 days of injury.
  • Mucosal web strictures resolve naturally in most cases between 30-60 days.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Prutton J S, Marks S L & Aleman M (2015) Endoscopic balloon dilation of esophageal strictures in 9 horses. J Vet Intern Med 29 (4), 1105-1111 PubMed.
  • Reichelt U, Hamann J & Lischer C (2012) Balloon dilation of oesophageal strictures in two horses. Equine Vet Educ 24 (8), 379-384 VetMedResource.
  • Tillotson K, Traub-Dargatz J L & Twedt D (2003) Balloon dilation of an esophageal stricture in a one-month-old Appaloosa colt. Equine Vet Educ 15 (2), 67-71 VetMedResource.
  • Feige K et al (2000) Esophageal obstruction in horses - a retrospective study of 34 cases. Can Vet J 41 (3), 207-210 PubMed.
  • Meyer G A et al (2000) The effect of oxytocin on contractility of the equine esophagus - a potent treatment for oesophageal obstruction. Equine Vet J 32 (2), 151-155 PubMed.
  • Knottenbelt D C et al (1992) Conservative treatment of esophageal stricture in five foals. Vet Rec 131 (2), 27-30 PubMed.
  • Craig D et al (1987) Surgical repair of an esophageal stricture in a horse. Vet Surg 16 (4), 251-254 PubMed.
  • Gideon L et al (1984) Esophageal anastomosis in two foals. JAVMA 184 (9), 1146-1148 PubMed.
  • Nixon A J et al (1983) Esophagomyotomy for relief of an intrathoracic esophageal stricture in the horse. JAVMA 183 (7), 794-796 PubMed.
  • Suann C J et al (1982) Oesophageal resection and anastomosis as a treatment for esophageal stricture in the horse. Equine Vet J 14 (2), 163-164 PubMed.
  • Fretz P B et al (1982) Repair of esophageal stricture in the horse. Mod Vet Pract 53 (6), 31-35 PubMed.

Other sources of information

  • Fubini S L (2019) Chapter 30: Esophagus. In: Equine Surgery. 5th edn. Eds: Auer J & Stick J. Saunders, USA. pp 474-496.
  • Jones S M & Blikslager A T (2004) Esophageal Stricture. In: Equine Internal Medicine. Saunders, USA. pp 860-861.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code