1887

Flexible endoscopy: oesophagoscopy

image of Flexible endoscopy: oesophagoscopy
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Abstract

Endoscopy is the best minimally invasive method for evaluating the oesophagus for inflammatory disease, strictures, foreign bodies and neoplasia. This chapter covers instrumentation, indications and contraindications, patient preparation and positioning, procedure, normal and pathological findings, and complications. The chapter also includes a video clip.

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Figures

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4.1 Normal oesophageal lumen of the dog showing imprints of the trachea in the 12 o’clock position.
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4.2 Distal third of the normal feline oesophagus showing linear striations and submucosal blood vessels.
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4.3 Normal open lower oesophageal sphincter showing the Z-line, a demarcation between the oesophageal mucosa and the redder gastric mucosa.
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4.5 Dog with severe erosive oesophagitis of unknown aetiology. Examination of oesophageal biopsy samples showed acute inflammation.
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4.6 Reflux oesophagitis in a young French Bulldog showing inflammatory streaks extending up the oesophagus from the open lower oesophageal sphincter. Oesophagitis resolved following management of the dog’s upper airway disease.
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4.7 (a) Withdrawal of the retroflexed endoscope in the ‘J’ position within the stomach allows visualization of the cardia. Drawn by S. J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. (b) When the stomach is distended with air and the endoscope is in the ‘J’ position, the imprint of the oesophageal hiatus is observed, with the fundic portion of the stomach protruding through the oesophageal hiatus.
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4.8 Gastro-oesophageal intussusception in a dog, showing the rugal folds of the stomach obstructing the oesophageal lumen. The dog required abdominal surgery to reduce the intussusception.
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4.9 Endoscopic view of a persistent right aortic arch entrapping the oesophagus at the base of the heart between the trachea (T) and the aorta (A). The oesophagus is dilated cranial to the entrapment.
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4.10 Oesophageal leiomyoma obstructing the distal oesophagus in a dog. Leiomyomas are characterized as a smooth submucosal mass protruding into the oesophageal lumen.
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4.11 A multilobed oesophageal carcinoma in the distal oesophagus, obstructing the oesophageal lumen.
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4.12 Endoscopic view of two oesophageal diverticula at 3 and 9 o’clock in the distal oesophagus that developed secondary to an oesophageal foreign body (a bone). The diverticula were closed surgically.
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4.13 Oesophageal foreign body graspers for removing large bone-type foreign bodies. The graspers can be passed either adjacent to the endoscope or through a large overtube. (© Karl Storz SE & Co. KG)
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4.14 Simple oesophageal stricture in a cat secondary to oesophagitis caused by a doxycycline tablet being lodged in the oesophagus. The stricture, which had a lumen diameter of 3 mm, was successfully managed with balloon dilation.

Supplements

A case of sliding hiatal hernia.

The endoscope in a j-flexed position looking at the lower oesophageal sphincter (abnormally dilated) in a patient presenting with chronic vomiting. A case of sliding hiatal hernia.

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