Search Results
Introduction Sliding hiatal hernia (SHH) occurs when the lower esophageal sphincter moves cranially through the esophageal hiatus and into the thoracic cavity, resulting in gastroesophageal reflux. 1 – 5 While gastroesophageal reflux disease
Objective
To determine long-term outcome of medical and surgical treatment of hiatal hernia (HH) in dogs and cats.
Design
Retrospective case series.
Animals
22 dogs and 5 cats.
Procedure
Medical records of dogs and cats with HH were reviewed. Outcomes of treatment were obtained from reexamination or owner questionnaires.
Results
The most common breeds affected were English Bulldog and domestic shorthair cat. Mean age of all dogs and cats was 4 years. Hiatal hernia was diagnosed by use of contrast radiography of the esophagus (n = 19), fluoroscopy (7), or esophagoscopy (1). Eight of 15 dogs and cats treated medically for 30 days had complete resolution of signs. Of the 7 in this group that did not respond, 1 died on the 10th day of medical treatment and the remaining 6 were treated surgically. Eight of 10 dogs that underwent hiatal plication, esophagopexy, and gastropexy responded favorably. Four of 7 dogs that underwent fundoplication did well. However, 3 of these dogs did not have clinical signs. Fundoplication was successful in only 1 of 4 dogs with clinical signs.
Clinical Implications
Dogs and cats with clinical signs of reflux esophagitis associated with HH should undergo conservative treatment for 30 days. Most will be managed successfully by use of drugs, dietary alterations, or both. Those that do not respond to conservative treatment will likely require surgery. The best prognosis after surgery appears to be associated with the esophagopexy technique. (J Am Vet Med Assoc 1998;213:381-384)
appeared normal. Differential diagnoses included hiatal hernia (HH), esophageal mass (eg, paraesophageal empyema), an intraluminal esophageal foreign body, and a pulmonary mass. Figure 2 Same radiographic views as in Figure 1 . Notice the oval
Summary
Liquid barium esophagraphy was done in 29 clinically normal Chinese Shar Pei pups and observed fluoroscopically, beginning when they were approximately 3 months old and repeated periodically until they were at least 18 months old, if possible. Of these dogs, 69% had relatively slow stimulation of secondary waves, 48% had generalized poor esophageal tone or motility, and 38% had esophageal redundancy. Sequential studies revealed apparent improvement with age for those dogs initially showing slow motility, provided that redundancy was not also present.
Another group of 9 Chinese Shar Pei pups had histories of either regurgitation or vomiting. Five of these had hiatal hernia and 2 had megaesophagus.
hernia. On the lateral radiographic view, the cranial thoracic esophagus appears to be dilated with fluid and gas ( Figure 2 ). Differential diagnoses included hiatal hernia, megaesophagus, and gastroesophageal intussusception. Figure 2— Same
Abstract
Objective—To evaluate the effect of body position on barrier pressure at the gastroesophageal junction in anesthetized Greyhounds and to assess alterations in barrier pressure following gastropexy.
Animals—8 adult Greyhounds.
Procedure—Barrier pressure at the gastroesophageal junction was measured by fast (1 cm/s) and slow (1 cm/10 s) withdrawal of a subminiature strain gauge transducer through the gastroesophageal junction in 8 anesthetized dogs. The effect of body position was measured. Each dog then was placed in right-lateral recumbency, and gastropexy was performed in the left flank. Additional measurements were obtained 1, 5, 10, 20, and 30 minutes after gastropexy.
Results—Barrier pressure for dogs positioned in sternal recumbency (mean ± SEM, 1.1 ± 0.53 mm Hg) was significantly less than for dogs positioned in right lateral or left lateral recumbency. Following gastropexy, there was a steady increase in barrier pressure. Thirty minutes after gastropexy, barrier pressure was significantly higher (13.36 ± 3.46 mm Hg), compared with the value before surgery.
Conclusions and Clinical Relevance—Barrier pressure in anesthetized dogs is highly variable and influenced by body position. This is most likely the result of anatomic interrelationships between the diaphragm, stomach, and terminal portion of the esophagus. Gastropexy also increases barrier pressure in the immediate postoperative period, which may be clinically relevant in terms of understanding how resolution of gastroesophageal reflux disease associated with hiatal hernia may be affected by gastropexy combined with hernia reduction. (Am J Vet Res 2001;62:1068–1072)
diagnoses for the soft tissue mass containing gastrointestinal structures were hiatal hernia, atypical congenital diaphragmatic hernia, or atypical diaphragmatic rupture. Figure 2 Same radiographic image as in Figure 1 . There is a large, well
shown to be involved in the incitement of reflux include the presence of a sliding hiatal hernia, reduced gastroesophageal junction pressure, esophagitis, obesity, increased distensibility of the gastroesophageal junction, prolonged esophageal clearance
were present, and the trachea was shifted rightward and ventrally. The liver appeared enlarged, had rounded margins, and was ventrally displaced. On the basis of radiographic findings, the primary differential diagnoses included hiatal hernia
