Surgical repair of an esophageal stricture in a horse.
Abstract: An esophageal stricture was diagnosed in a 9-month-old quarterhorse by esophagoscopy and positive pressure contrast esophagography. Medical management and two attempts at surgical intervention were unsuccessful. The initial surgical technique used was a linear esophagotomy, mucosal resection and anastomosis, and closure of the muscular tunic, which resulted in a more severe stricture. The second surgical procedure was interruption of the stricture cicatrix by a single linear esophagotomy and primary closure of only the esophageal muscular tunic. This technique resulted in an increased lumen diameter, but failed to adequately resolve the stricture. Successful resolution of the stricture with return to a normal diet was achieved by a two stage repair using formation of an esophagostomy to stabilize the esophagus, followed by fenestration of the mucosal-submucosal cicatrix. Six months postoperatively, the horse was asymptomatic on a normal diet.
Publication Date: 1987-07-01 PubMed ID: 3507152DOI: 10.1111/j.1532-950x.1987.tb00948.xGoogle Scholar: Lookup
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Summary
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The research examines the diagnosis and multiple treatment attempts of an esophageal stricture in a quarterhorse. Despite initial unsuccessful surgeries, the condition was finally resolved using a two stage repair, resulting in the horse returning to a normal diet without symptoms.
Diagnosis of Esophageal Stricture
- The esophageal stricture, a narrowing of the esophagus that causes swallowing difficulties, was diagnosed in a 9-month-old quarterhorse using esophagoscopy and positive pressure contrast esophagography. These procedures allowed the researchers to visualize and detect the stricture.
Initial Surgical Interventions
- The initial treatment approach was through medical management and surgical intervention. However, these were unsuccessful in resolving the stricture.
- The first surgery performed was a linear esophagotomy, mucosal resection and anastomosis, and closure of the muscular tunic. Basically, an incision was made into the esophagus, the mucosal layer of the stricture was removed and the ends were stitched back together, then the muscle layer of the esophagus was closed. However, rather than resolving the stricture, this procedure resulted in a more severe stricture.
Second Surgical Intervention
- The second surgical approach involved interruption of the stricture cicatrix through a single linear esophagotomy, and primary closure of only the esophageal muscular tunic. This essentially meant cutting into the scar tissue formed by the stricture and stitching the muscular layer of the esophagus.
- Although this method resulted in an increased diameter of the esophagus lumen, it didn’t sufficiently resolve the stricture.
Successful Two-Stage Repair process
- Resolution of the stricture was eventually achieved by a two-stage repair.
- The first stage involved formation of an esophagostomy to stabilize the esophagus. An esophagostomy is a surgical procedure where an opening is created in the neck through to the esophagus.
- In the second stage, the researchers carried out a fenestration of the mucosal-submucosal cicatrix. This involves creating small holes in the scar tissue formed by the stricture, allowing it to break down and the stricture to resolve.
- Following this two-stage repair, the horse was able to return to a normal diet.
Postoperative Outcomes
- Six months after the two-stage repair, the horse was asymptomatic — it showed no signs of disease — and was maintaining a normal diet.
Cite This Article
APA
Craig D, Todhunter R.
(1987).
Surgical repair of an esophageal stricture in a horse.
Vet Surg, 16(4), 251-254.
https://doi.org/10.1111/j.1532-950x.1987.tb00948.x Publication
Researcher Affiliations
- New York State College of Veterinary Medicine, Cornell University, Ithaca 14850.
MeSH Terms
- Anastomosis, Surgical / veterinary
- Animals
- Cicatrix / complications
- Cicatrix / veterinary
- Esophageal Fistula / veterinary
- Esophageal Stenosis / diagnostic imaging
- Esophageal Stenosis / surgery
- Esophageal Stenosis / veterinary
- Esophagoscopy / veterinary
- Esophagostomy / veterinary
- Esophagus / surgery
- Horse Diseases / surgery
- Horses
- Postoperative Complications / veterinary
- Radiography
Citations
This article has been cited 1 times.- Koenig JB, Silveira A, Cribb NC, Piat P, Laverty S, Sorge US. Clinical indications, complications, and long-term outcome of esophageal surgeries in 27 horses.. Can Vet J 2016 Dec;57(12):1257-1262.
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