Gastroesophageal intussusception is a rare gastrointestinal disease of primarily young dogs characterized by invagination of the stomach into the caudal esophagus.
Although the stomach is primarily involved in the intussusceptum, other organs such as the duodenum or spleen can also be involved.
Young dogs appear to be less clinically affected, but in older dogs, this is usually a life-threatening condition that requires an accurate, swift diagnosis with immediate surgical intervention.
A breed predisposition has been noted in the German Shepherd but any breed may be affected, and male are more commonly involved. A predisposition to this disease in dogs is more common with megaesophagus, and has been reported following pneumonectomy and respiratory distress syndrome.
Initial symptoms may include vomiting, abdominal discomfort, hematemesis, dyspnea. Marked deterioration coincides with acute gastric ischemia and esophageal distension leading to pulmonary compression, hypotension, shock and cardiac arrest.
In other cases, only mild intermittent vomiting may be evident prior to diagnosis.
In young pups, radiographs may not show any abnormality and endoscopic examination is required for definitive diagnosis.
Diagnosis is based on barium-meal radiographs or CT scans, showing invagination of the anterior pylorus into the esophagus without other abdominal organs present in the deficit. The cranial esophagus is often dilated with gas while the caudal esophagus is distended with a soft-tissue dense mass.
Temporary alleviation of esophageal distention can be achieved via nasogastric tubing, allowing time to institute aggressive intravenous fluid therapy, correction of metabolic alkalosis and any fluid deficits.
Surgical intervention usually requires general anesthesia followed by open-surgical belt-loop gastropexy, bilateral incisional gastropexy (attaching the gastric fundus and body to the left and right body walls) or endoscopic gastropexy.
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