Dr.

Akil Farouk Internal veterinary Medicine 4th class -2022

Diseases of Oesophagus

A) Esophagitis:
Is the inflammation of oesophagus.

Causes:

1. Primary esophagitis caused by the ingestion of chemical or physical irritants is

usually accompanied by stomatitis and pharyngitis.
2. Laceration of the mucosa by a foreign body or complications of nasogastric
intubation can occur.
3. Nasogastric intubation is associated with a higher risk of pharyngeal and
oesophageal injury when performed in horses examined for colic (larger
diameter nasogastric).

Pathogenesis :

Inflammation of the oesophagus combined with local oedema and swelling results
in a functional obstruction and difficulty in swallowing.

Clinical Findings :

1. In the acute esophagitis, there is salivation and attempts to swallow, which cause
severe pain, particularly in horses.
2. In some cases, attempts at swallowing are followed by regurgitation and
coughing, pain, retching activities.

Clinical Pathology:

In severe esophagitis of traumatic origin, a marked neutrophilia can occur,

suggesting active inflammation.

Treatment:
1. Feed should be withheld for 2 to 3 days and fluid and electrolyte therapy can be
necessary for several days.
2. Parenteral antimicrobials are indicated.

1
Dr. Akil Farouk Internal veterinary Medicine 4th class -2022

B) Oesophageal Rupture:
Rupture of the oesophagus is usually traumatic and can be life-threatening.

Causes:

1. localized ischemia and necrosis secondary to long-standing impaction or

obstruction by foreign bodies or feed material.
2. External trauma.
3. Nasogastric intubation.

Pathogenesis:

Traumatic injury to the oesophagus results in oedema, haemorrhage, laceration of the

mucosa, and possible perforation of the oesophagus, resulting in periesophageal
cellulitis, which spreads proximally and distally along the oesophagus in fascial planes
from the site of perforation.

Clinical Findings:

1. In the acute injury of the oesophagus, there is salivation and attempts to

swallow, which cause severe pain, particularly in horses.
2. In some cases, attempts at swallowing are followed by regurgitation and
coughing and pain.
3. Marked drooling of saliva, grinding of the teeth, coughing, and profuse
nasal discharge are common in the horse with oesophageal trauma.
4. Regurgitation can occur and the regurgitus contains mucus and some fresh
blood.
5. Animals that recover from oesophageal traumatic injury are commonly
affected by chronic oesophageal stenosis with distension above the
stenosis.

Clinical Pathology:

• There is often haematological evidence of inflammation,

dehydration, metabolic alkalosis, and toxaemia.

2
Dr. Akil Farouk Internal veterinary Medicine 4th class -2022

Differential Diagnosis:

• Tracheal laceration and subcutaneous emphysema

- Skin wounds over the axilla with subsequent subcutaneous emphysema
- Severe guttural pouch empyema.
• Clostridial myositis secondary to puncture wounds of the neck or
cervical intramuscular injections
• Pharyngeal phlegmon in cattle.

Treatment:

1. Effective drainage of the site over the oesophageal perforation,

prevention of further contamination, control of infection and
inflammation, and provision of water and food.
2. Loss of saliva can cause important abnormalities in electrolyte and
acid base status, and horses should be supplemented with sodium
and potassium chloride.
3. Broad spectrum antimicrobials and tetanus prophylaxis should be
administered.
4. Pain and swelling can be controlled by administration of
NSAIDs (nonsteroidal anti-inflammatory drugs: are a type of pain
reliever).

C) Oesophageal Obstruction:

Causes:
1. Intraluminal and caused by swallowed material.
2. Extraluminal caused by pressure on the oesophagus by surrounding
organs or tissues (diseases).
3. Oesophageal paralysis can also result in obstruction, for example, in
horses with grass sickness.

Clinical signs:

Acute Obstruction: Cattle:

1. The animal suddenly stops eating and shows anxiety and restlessness.
2. There are forceful attempts to swallow and regurgitate, salivation,
coughing, and continuous chewing movements.
3
Dr. Akil Farouk Internal veterinary Medicine 4th class -2022

3. If obstruction is complete, bloating occurs rapidly and adds to the

animal’s discomfort. Ruminal movements are continuous and forceful
and there can be a systolic murmur audible on auscultation of the heart.

Horses:

1. Dysphagia with nasal reflux of saliva, feed, and water.

2. Affected horses will usually not attempt further eating but will drink
and attempt to swallow water.
3. External palpation of the cervical oesophagus can reveal a firm
cylindrical swelling along the course of the neck on the left side when
the oesophagus is obstructed with feed.
4. Passage of a nasogastric tube is necessary to make the diagnosis and to
assess the level of the obstruction. The level of obstruction can be
approximated by the amount of tube that has been passed.
5. Persistent obstruction can occur in the horse and death can occur in either
species from subsequent aspiration pneumonia or, when the
obstruction persists, from dehydration.

Chronic Obstruction:

1. In cattle, chronic bloat, which is usually of moderate severity and can persist
for several days without the appearance of other signs.
2. Swallowing movements are usually normal until the bolus reaches the
obstruction, when they are replaced by more forceful movements. Dilatation of
the oesophagus can cause a pronounced swelling at the base of the neck.

Clinical Pathology:

• Laboratory tests are not used in diagnosis, although radiographic

examination is helpful to outline the site of stenosis, diverticulum,
or dilatation, even in animals as large as the horse.
•

Differential Diagnosis:

• The clinical findings of acute oesophageal obstruction in

cattle and horses are usually typical but can be similar to
those of esophagitis, in which local pain is more apparent
and there is often an accompanying stomatitis and
pharyngitis. Chronic obstruction
4
Dr. Akil Farouk Internal veterinary Medicine 4th class -2022
• Differentiation of the causes of chronic obstruction can be
difficult. A history of previous esophagitis or acute
obstruction suggests cicatricial stenosis. Contrast
radiography of the oesophagus is valuable in the
investigation of horses with dysphagia, choke, and
nasogastric reflux.
• Equine encephalomyelitis and botulism are other diseases
in which there is difficulty in swallowing.

Treatment (Most important points):

1. Conservative approach, many obstructions will resolve

spontaneously and a careful conservative approach is
recommended. It can require several hours of monitoring, re-
examination, and repeated sedation before the obstruction is
resolved. During this time, the animal should not have access to
feed and water.
2. Sedation, in acute obstruction, if there is marked anxiety and
distress, the animal should be sedated before proceeding with
specific treatment. Administration of a sedative such as an α2
receptor agonist, with or without an opiod, can also help to relax
the oesophageal spasm and allow passage of the impacted
material. For sedation and oesophageal relaxation in the horse,
one of the following is recommended:

• Acepromazine 0.05 mg/kg BW intravenously or Xylazine 0.5

to 1.0 mg/kg BW intravenously.

3. Pass a stomach tube and allow object to move into stomach.

4. Removal (specific foreign body) by Endoscope.
5. Manual Removal Through Oral Cavity in Cattle. Antimicrobial
Administration
6. Animals with prolonged obstruction (>12– 24 hours), fever, abnormal lung sounds,
ultrasonographic or radiographic evidence of aspiration, or in which there is a
suspicion of aspiration of regurgitus should be administered broad.

For more details please read this reference:

Peter et al., (2017). Veterinary medicine: a textbook of the diseases of cattle, horses,
sheep, pigs and goats. 11th Edition. Pp:196-203 Elsevier publisher.