Concurrent gastro-oesophageal intussusception, trichobezoar and hiatal hernia in a cat

Abstract

Gastro-oesophageal intussusception is a rare condition in cats. Its aetiology in relation to a pre-existing hiatal hernia and a trichobezoar is discussed.

Intermittent Gastroesophageal Intussusception in a Kitten Resolved with a Percutaneous Gastropexy

“…Some authors have suggested a relation with diverse esophageal abnormalities such as megaesophagus [8,10,12], incompetence of the lower esophageal sphincter which often occurs secondary to sliding hiatal hernias, different causes of increased intrabdominal pressure such as chronic vomiting or blunt trauma, and negative intrathoracic pressure from inspiratory dyspnea due to chronic upper airway obstruction or severe respiratory disease [6,10].…”

“…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].…”

“…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]. A clinical case of GEI has been described associated with chronic intermittent vomiting secondary to a hiatal hernia and the presence of a trichobezoar impacted in the GEI [6], secondary to a diaphragmatic hernia [4]. In another clinical case GEI was suggested as a cause of secondary nutritional hyperparathyroidism, justifi ed by hypocalcemia resulting in muscular malfunction and weakness [8]; however, this last association was not conclusively demonstrated.…”

“…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].…”