Esophageal Stricture

Esophageal Stricture



Basic Information image



Definition


Stricture (narrowing of the lumen) of the esophagus



Synonyms


Esophageal webs or rings



Epidemiology



Risk Factors




• Esophageal obstruction


• Esophagitis



Associated Conditions and Disorders


Esophageal stricture may occur after esophageal obstruction, especially chronic obstruction, or circumferential esophageal erosion or ulceration. Stricture may also occur after trauma to the neck. Congenital strictures have been reported rarely.



Clinical Presentation



History, Chief Complaint


Clinical signs of esophageal stricture are similar to those of esophageal obstruction, including acute onset of excessive salivation, retching (repeated flexion and extension of the neck), coughing, and copious discharge of saliva from the nostrils. Repeated bouts of esophageal obstruction may occur.



Physical Exam Findings


The findings of physical examination are identical to those of esophageal obstruction.



Etiology and Pathophysiology




• Esophageal strictures may develop in three forms:


image Mural lesions that involve only the adventitia and muscularis

image Esophageal rings or webs that involve only the mucosa or submucosa

image Annular stenosis that involves all layers of the esophageal wall


Diagnosis image



Differential Diagnosis




• Other causes of dysphagia (especially abnormalities of the pharyngeal and esophageal phases of deglutition), including pharyngeal paralysis, pharyngeal cysts, pharyngeal compression by strangles abscesses and guttural pouch empyema, subepiglottic cyst, fourth branchial arch defect, esophageal obstruction, megaesophagus, esophagitis, intramural esophageal cysts, esophageal rupture, and equine grass sickness


• Repeated bouts of esophageal obstruction should increase the suspicion of an underlying esophageal stricture.



Initial Database




• The leukogram and hematology results are likely to be normal unless there is dehydration from chronic esophageal obstruction.


• Confirmation of esophageal stricture can be made in some cases by endoscopic examination (esophagoscopy). Esophageal webs and rings can often be detected by endoscopy, but mural strictures or annular stenosis may not be visible.

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

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