The term “hiatal disease” indicates a number of diseases affecting the lower esophageal sphincter (LES) or the esophageal hiatus of the diaphragm that in most cases result in reflux esophagitis. Hiatal disease may result from: 1) defects in the embryonic development of the esophageal hiatus (congenital form); 2) factors altering the pressure of the LES (hiatal hernia, chronic vomiting, delayed gastric emptying, general anesthesia, surgical Trendelembur position, nasogastric and pharingogastric tube placement); 3) abdominal trauma causing a sudden increase in intra-abdominal pressure. Hiatal disease can cause clinical signs itself, but of more significance is its role in the development of gastroesophageal reflux and esophagitis. Factors responsible of reflux esophagitis are many and include the composition of the refluxed material, volume and frequency of reflux, contact time of reflux with the esophageal mucosa, integrity of the esophageal mucosal barrier and efficiency of the esophageal clearance. Clinical signs of reflux esophagitis depend on the severity of the esophageal lesions and on the nature of the underlying disease, and include anorexia, dysphagia, odynophagia, excessive salivation and regurgitation of thick, white saliva. Vomiting resulting from the hiatal disease may be associated. Among the different hiatal diseases, we consider cardial incompetence, hiatal hernia (sliding hernia and para-esophageal hiatal hernia) and gastroesophageal intussusception. Severe complications such as stricture and ulceration of the esophageal wall are frequent in chronic gastresophageal reflux secondary to cardial incompetence and/or hiatal hernia. A complication not reported in animals but well described in man has been observed recently by authors in cats affected by gastresophageal reflux. In the distal esophagus, the normal squamous epithelium was replaced by wide areas of metaplastic columnar epithelium; the lesion is comparable to Barrett’s esophagus in men.
Hiatal diseases: causes, complications and treatment / M. Gualtieri. ((Intervento presentato al 14. convegno ECVIM-CA tenutosi a Barcellona nel 2004.
|Titolo:||Hiatal diseases: causes, complications and treatment|
GUALTIERI, MASSIMO (Primo)
|Data di pubblicazione:||2004|
|Parole Chiave:||Esophagus; endoscopy; esophagitis; gastroesophageal reflux|
|Settore Scientifico Disciplinare:||Settore VET/09 - Clinica Chirurgica Veterinaria|
Settore VET/08 - Clinica Medica Veterinaria
Settore VET/02 - Fisiologia Veterinaria
Settore VET/03 - Patologia Generale e Anatomia Patologica Veterinaria
|Enti collegati al convegno:||European college of veterinary internal medicine : companion animals|
|Citazione:||Hiatal diseases: causes, complications and treatment / M. Gualtieri. ((Intervento presentato al 14. convegno ECVIM-CA tenutosi a Barcellona nel 2004.|
|Appare nelle tipologie:||14 - Intervento a convegno non pubblicato|
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