Page 341 - Feline diagnostic imaging

22.2 ­sophageal Masses 349

(a)

(b)

Figure 22.2 Radiographs of an 8-year-old domestic shorthair with an esophageal stricture (arrow) secondary to lymphocytic
plasmacytic esophagitis. A pulsion diverticulum was seen cranial to the stricture on fluoroscopy. (a) Lateral projection obtained during
fluoroscopy. Barium appears black in this image. (b) Lateral projection made later in the procedure. Colors have been inverted causing
the image to appear as a traditional radiograph.

22.2.1 Megaesophagus commonly, barium paste is used initially followed by a
“barium burger” (kibbled or canned cat food mixed with
Megaesophagus (Figures 22.4 and 22.5) can be congenital liquid barium) [7]. Some animals have more difficulty with
or acquired. Although a typical clinical sign is regurgita- liquids but others have more difficulty with solids so it is
tion, owners may confuse regurgitation with vomiting and important to test with both. Retention of the paste or bar-
may report that the animal is vomiting. On radiography, ium burger confirms the diagnosis.
the esophagus may be enlarged and distended with gas or
ingesta. A diverticulum may form where the esophagus
drapes over the trachea and may show as increased opacity 22.2.2 Vascular Ring Anomalies
in the cranial thorax. The presence of gas may allow the
esophageal wall to be seen (esophageal stripe sign). In Vascular ring anomalies [1,7] can encircle and constrict the
chronic cases, the trachea is depressed and there may be esophagus, resulting in dilation of the esophagus proxi-
concurrent aspiration pneumonia. mal to the obstruction. The most common is persistent
When the condition is not apparent on survey radiogra- right aortic arch (PRAA) although other anomalies have
phy, contrast radiography can aid in the diagnosis. been reported. On survey radiography, an enlarged gas‐ or
Additionally, fluoroscopy can be used to further character- food‐filled esophagus may be visible cranial to or cranial
ize megaesophagus and aid in diagnosing the cause. Most and caudal to a constriction at the heart base. In some