Primary bronchoesophageal fistula or tracheoesophageal fistula are a congenital disease of dogs characterized by an abnormal connection between the respiratory system and esophagus.
This condition usually arises as a result of an aberrant formation of the respiratory tract from the embryologic digestive tract and a predisposition has been reported in the Cairn Terrier.
Bronchoesophageal fistulas usually communicate with the left caudal lung lobe in dogs (although other lung lobes have been reportedly affected). The fistulas may also be associated with esophageal diverticula (congenital or acquired).
Clinical symptoms usually occur in young, small-breed dogs and include chronic coughing and regurgitation, often aggravated by eating or drinking. In dogs with anorexia, fever and lethargy, secondary pneumonia may also be present.
Radiography usually reveals an esophageal diverticulum, regional megaesophagus and focal interstitial densities in the right caudal and middle lung lobes. Using fluoroscopy and contrast radiography, contrast material may be seen accumulating in the diverticulum and refluxing into the right middle, caudal, and accessory bronchi. Use of a small amount of barium is recommended as iodinated contrast agents are hyperosmolar and can cause pulmonary edema.
Treatment is curative with surgical intervention in cases of congenital or foreign-body fistulas, consisting of a lung lobectomy and repair of the defect in the esophagus using a lateral thoracotomy approach.
With invasive neoplasia, surgical intervention, such as surgical resection/repair of the fistula carries high mortality and morbidity.
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- Merck Vet Manual
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