Balloon dilation to treat oesophageal strictures in five foals

Abstract

Summary Oesophageal stricture is a rare disorder in foals. The following manuscript describes the successful treatment of oesophageal strictures with balloon dilation in 5 foals aged 3 weeks to 4 months. Three of the foals presented due to recurrent oesophageal obstruction, one due to dysphagia, and one due to weight loss, pytalism and bruxism. The strictures were diagnosed via endoscopy. In 2 cases, the use of intraoesophageal corticosteroid injection was performed to reduce the incidence of oesophageal stricture reoccurrence. In all cases, a satisfactory outcome with resolution of clinical signs was achieved.

Curative balloon dilation of a severe esophageal stricture in a pig

“…34,35 In equine medicine, balloon dilation has been used for both acquired and congenital strictures in foals and adult horses. 33,36 Advantages of this procedure in equine medicine include the ability to use standing sedation rather than general anaesthesia and the treatment of strictures located in the thoracic region of the esophagus. Risks of balloon dilatation include esophageal perforation, re-stenosis, diverticulum formation, stricture formation, perioesophageal infection, pleural effusion and melena.…”

“…Risks of balloon dilatation include esophageal perforation, re-stenosis, diverticulum formation, stricture formation, perioesophageal infection, pleural effusion and melena. 33,36 A porcine model was used to evaluate the feasibility and safety of a balloon dilation catheter. 37 It was not reported if the pigs had any evidence of gastric ulceration; however, there was no evidence of stricture.…”

“…Treatment of esophageal strictures or achalasia by dilation has been successful in human medicine since the 1900s 32 . Endoscopic balloon dilation was effective in both adults and children with esophageal strictures 33 . Balloon dilation was also effective in alleviating esophageal strictures in companion animals 34,35 .…”

Primary esophageal obstruction in nursing foals – a retrospective analysis of 20 patients: clinical presentation, disease course and complications

“…Um die Entstehung von Strikturen zu minimieren, werden bei der Behandlung von epithelialen und subepithelialen Schleimhautläsionen nichtsteroidale Antiphlogistika eingesetzt (Sanchez 2010). Auch die lokale oder systemische Behandlung mit Kortikosteroiden wird zur Reduktion einer Narbenbildung eingesetzt (Ramage et al 2005, Chidlow et al 2015, Prutton et al 2015. Kortikosteroide verzögern die Kollagensynthese und fördern die Epithelisierung (Todhunter et al 1984).…”

“…In Fällen, bei denen keine tieferen Schichten der Ösophaguswand betroffen sind, kann der Ösophagus durch eine spezielle progressive Fütterung (d.h. nach anfänglich flüssiger Diät wird schrittweise wieder normales Futter angeboten) gewissermaßen "trainiert" werden (Knottenbelt et al 1992, Velde et al 2011, Stick 2012. Kongenitale und erworbene Ösophagusstrikturen können beim Fohlen durchaus erfolgreich mit einer Ballondilatation (Bougierung) therapiert werden, wozu in der Literatur Einzelfälle aufgelistet werden (Tillotsen et al 2003, Berlin et al 2015, Chidlow et al 2015. Des Weiteren sind spezielle Resektionsverfahren zur Behandlung von Ösophagusstrikturen beschrieben (Gideon 1984, Craig et al 1989.…”