Esophageal Rupture

Esophageal Rupture



Basic Information image



Definition


Rupture of the wall of the esophagus



Synonym


Esophageal perforation



Epidemiology



Risk Factors




• Chronic esophageal obstruction


• Kick wounds to the neck region



Associated Conditions and Disorders


Esophageal rupture may occur after esophageal obstruction, especially chronic obstruction, or as an extension of infection or injury from surrounding tissues.



Clinical Presentation



History, Chief Complaint


Clinical signs of esophageal rupture include cervical swelling, cellulitis, abscess formation, and subcutaneous emphysema. With open perforations, there is a wound from which saliva and food may drain.



Physical Exam Findings


In addition to the presenting signs listed above, affected horses may be febrile and have congested mucous membranes. Dyspnea may develop because of tracheal compression or obstruction or pleuritis.



Etiology and Pathophysiology




• Chronic obstruction of the esophagus may cause pressure-induced necrosis of the esophageal wall.


• Swallowed perforating foreign body


• Penetrating external wounds, especially kick wounds


• Repeated traumatic nasogastric intubation



Diagnosis image



Differential Diagnosis




• Other causes of cellulitis of the neck


• Other causes of subcutaneous emphysema (eg, thoracic wounds)


• Other causes of dyspnea



Initial Database




• The leukogram may reveal a leukopenia with or without a left shift and hypoproteinemia.


• Confirmation of esophageal rupture may be aided by endoscopic examination (esophagoscopy). Ruptures of the cranial esophageal sphincter may be very difficult to visualize with esophagoscopy. The more distal esophageal ruptures are easier to see using esophagoscopy.

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Esophageal Rupture

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