Idiopathic megaoesophagus and intermittent gastro‐oesophageal intussusception in a cat

Abstract

An eight-month-old domestic shorthair cat was presented with chronic vomiting for three months, with an acute increase in frequency during the past two days. A diagnosis of megaoesophagus was made by chest radiography. Diagnostic work-up for megaoesophagus was performed. A gastro-oesophageal intussusception was identified during endoscopy. Medical and nutritional therapy was instituted with a good response to the treatment.

Intermittent Gastroesophageal Intussusception in a Kitten Resolved with a Percutaneous Gastropexy

“…Some authors have categorized GEI as a sliding hiatal hernia as it is defi ned as a transposition of the abdominal part of the esophagus, gastroesophageal junction and a portion of stomach through the esophageal hiatus of the diaphragm [10,11]; however, this is different than GEI because the gastroesophageal junction does not move cranially into the thorax [7,10]. Occasionally, the spleen, duodenum, pancreas, and omentum may be trapped within the invagination [10].…”

“…On the principal international scientifi c databases, there are only fi ve clinical cases of GEI in domestic cats reported between 1998 to 2015 in domestic shorthair cats [5,7,8], in a Himalayan [4] and in a Birman [6], including four males and one female; two were kittens, two adults and the last an elder cat, age ranged from 4 months to 15 years old. The clinical cases presented different clinical signs referring to gastrointestinal symptoms such as vomitus or regurgitation [6][7][8] or respiratory disease such as respiratory distress, open-mouth breathing, inspiratory stridor and mucopurulent nasal discharge, with acute or intermittent presentation [4,8].…”

“…Uncomplicated reduction of the GEI was achieved by a combination of infl ation pressure of the esophagus and gentle advancement of the endoscope according with the technic described by Sherding and Johnson [9]; the gastric mucosa appeared macroscopically intact in the repositioned stomach. With a diagnosis of GEI associated with megaesophagus and according to van Geffen et al [7], we decided to attempt medical management: fl uid therapy with maintenance crystalloids, omeprazole, cisapride, and a moist low fat diet (Gastro Intestinal High Energy, Royal Canin, USA) in several meals a day in an upright position. For the next eight days, the patient presented intermittent respiratory distress two to four times per day, both in relation to meals and not, accompanied by cyanosis, syncope and abdominal discomfort.…”

“…GEI has been rarely reported in animal species such as the dog [10,11], cat [4][5][6][7][8], leopard (Panthera pardus) [12], cheetah (Acinonyx jubatus) [9] and hedgehog (Atelerix albiventris) [13]. Some authors have categorized GEI as a sliding hiatal hernia as it is defi ned as a transposition of the abdominal part of the esophagus, gastroesophageal junction and a portion of stomach through the esophageal hiatus of the diaphragm [10,11]; however, this is different than GEI because the gastroesophageal junction does not move cranially into the thorax [7,10].…”

“…Until 2014, only three case studies on esophageal diseases were published, describing esophageal dysmotility due to different origins as the principal pathology [1][2][3]; however, none of these studies refers to a gastroesophageal intussusception (GEI), a rare pathology characterized by an invagination of the stomach into the lumen caudal to the thoracic esophagus [4][5][6][7][8].…”