RESUMO
Background: Nasopharyngeal polyps are benign and inflammatory masses assumed to arise from the middle ear or the eustachian tube with extension into the pharynx. The most common clinical signs associated with nasopharyngeal polyps include respiratory stertor, dyspnea, and otic discharge. Neurological signs, including head tilt, facial nerve paralysis, and ataxia, might indicate concurrent involvement of the middle or inner ear. The objective of the current report is to describe a case of a feline nasopharyngeal polyp with a concurrent hiatal hernia and megaesophagus, both spontaneously resolved after removal of the polyp. Case: A 6-month-old female intact domestic shorthair cat was presented for evaluation of lethargy, anorexia, and upper respiratory signs, such as stridor, stertor, and dyspnea. A thoracic radiography revealed esophageal dilation caudal to the cardiac silhouette, suggestive of megaesophagus with gaseous filtration. An esophagram confirmed a hiatal hernia and megaesophagus. Computed tomography revealed a nasopharyngeal mass adjacent to the soft palate and a soft-tissue density in the right tympanic bulla. A tentative diagnosis of a nasopharyngeal polyp was made. After the ventral bulla osteotomy, the nasopharyngeal mass was removed by a gentle traction avulsion technique. Six days after the surgery, hiatal hernia and megaesophagus were spontaneously resolved. Based on histopathologic exam, the mass was found to be an inflammatory nasopharyngeal polyp. Two months after surgery, the owner reported that the patient's condition had returned to baseline with a good appetite, and the thoracic radiography was within normal limit. Discussion: For successful treatment of a nasopharyngeal polyp, traction avulsion of the polyp with or without a ventral bulla osteotomy is recommended. However, in patients with otitis media, a ventral bulla osteotomy followed by traction avulsion of the polyp is recommended in order to reduce the rate of polyp recurrence. Common clinical signs of a nasopharyngeal polyp are stertor, stridor, dyspnea, dysphagia, and open-mouth breathing, which are identified in a chronic upper airway obstruction. A hiatal hernia secondary to a nasopharyngeal polyp has not been reported so far. However, a relationship between chronic upper airway obstruction and hiatal hernias has been proposed previously. Moreover, hiatal hernia resolved spontaneously after removal of the nasopharyngeal polyp suggests that the occurrence of the hiatal hernia was secondary to the nasopharyngeal polyp. In addition to the hiatal hernia, megaesophagus was also identified in the present case. Megaesophagus secondary to a chronic upper airway obstruction from a nasopharyngeal obstruction has been reported. However, megaesophagus is also thought to occur secondary to hiatal hernias. Therefore, in the current study, it is unclear whether the megaesophagus was solely a result of the obstructive nature of the nasopharyngeal polyp or a combination of the hiatal hernia and the nasopharyngeal polyp. In conclusion, any cat with clinical signs of an upper airway obstruction and a concurrent hiatal hernia and megaesophagus should be thoroughly investigated for a nasopharyngeal polyp, as well as other gastrointestinal and systemic causes. Furthermore, this case suggests that the prognosis for a concurrent hiatal hernia and megaesophagus is good in cats if the nasopharyngeal polyp is properly removed.
Assuntos
Animais , Feminino , Gatos , Osteotomia/veterinária , Acalasia Esofágica/veterinária , Pólipos Nasais/veterinária , Orelha Média/cirurgia , Hérnia Hiatal/veterinária , Doenças Nasofaríngeas/veterináriaRESUMO
Os tumores do sistema digestório não são comuns na medicina veterinária e as neoplasias de estômago representam menos de 1% de todos os tumores malignos. O leiomiossarcoma é o segundo tumor que mais acomete o trato gastrointestinal de cães, com predisposição para as regiões de jejuno e ceco, mas qualquer porção pode ser afetada, desde o esôfago até o reto. O presente trabalho relata um caso em um canino da raça Shar-pei, macho, com 13 anos de idade e histórico de episódios eméticos pós- prandiais e emagrecimento progressivo havia oito meses. Após avaliação radiográfica e endoscópica, foi indicada intervenção cirúrgica e observada tumoração gástrica associada a hérnia de hiato. O diagnóstico de leiomiossarcoma gástrico foi estabelecido por meio de análise histopatológica. O paciente apresentou pouco tempo de sobrevida, entretanto destaca-se a raridade desse tipo de neoplasia gástrica e da associação desse tipo tumoral com hérnias de hiato, assim como a importância da análise histopatológica para o correto diagnóstico desse tipo de patologia.(AU)
Gastrointestinal system tumors are not common in Veterinary Medicine and stomach neoplasia represents less than 1% of all malignant tumors. Among digestive neoplasias, the leiomyosarcoma is the second most common with predisposition to the regions of the jejunum and cecum, but any portion from the esophagus to rectum can be potentially affected. This is a case report of a 13-year-old male Shar-pei dog with medical history of post prandial emetic episodes and progressive weight loss lasting eight months. Surgical intervention was indicated after radiographs and endoscopic evaluation, where a gastric mass and hiatal hernia were found. The diagnosis of gastric leiomyosarcoma was established only after histopathological analysis. Despite the patient having little survival time, this clinical presentation of a gastric tumor associated with hiatal hernia is rare, and exalts the importance of histopathological studies as a tool for the correct diagnosis in these unusual diseases.(AU)
Assuntos
Animais , Cães , Hérnia Hiatal/veterinária , Leiomiossarcoma/veterinária , Neoplasias do Sistema Digestório/veterinária , Neoplasias Gástricas/veterináriaRESUMO
Os tumores do sistema digestório não são comuns na medicina veterinária e as neoplasias de estômago representam menos de 1% de todos os tumores malignos. O leiomiossarcoma é o segundo tumor que mais acomete o trato gastrointestinal de cães, com predisposição para as regiões de jejuno e ceco, mas qualquer porção pode ser afetada, desde o esôfago até o reto. O presente trabalho relata um caso em um canino da raça Shar-pei, macho, com 13 anos de idade e histórico de episódios eméticos pós- prandiais e emagrecimento progressivo havia oito meses. Após avaliação radiográfica e endoscópica, foi indicada intervenção cirúrgica e observada tumoração gástrica associada a hérnia de hiato. O diagnóstico de leiomiossarcoma gástrico foi estabelecido por meio de análise histopatológica. O paciente apresentou pouco tempo de sobrevida, entretanto destaca-se a raridade desse tipo de neoplasia gástrica e da associação desse tipo tumoral com hérnias de hiato, assim como a importância da análise histopatológica para o correto diagnóstico desse tipo de patologia.(AU)
Gastrointestinal system tumors are not common in Veterinary Medicine and stomach neoplasia represents less than 1% of all malignant tumors. Among digestive neoplasias, the leiomyosarcoma is the second most common with predisposition to the regions of the jejunum and cecum, but any portion from the esophagus to rectum can be potentially affected. This is a case report of a 13-year-old male Shar-pei dog with medical history of post prandial emetic episodes and progressive weight loss lasting eight months. Surgical intervention was indicated after radiographs and endoscopic evaluation, where a gastric mass and hiatal hernia were found. The diagnosis of gastric leiomyosarcoma was established only after histopathological analysis. Despite the patient having little survival time, this clinical presentation of a gastric tumor associated with hiatal hernia is rare, and exalts the importance of histopathological studies as a tool for the correct diagnosis in these unusual diseases.(AU)
Assuntos
Animais , Cães , Leiomiossarcoma/veterinária , Hérnia Hiatal/veterinária , Neoplasias Gástricas/veterinária , Neoplasias do Sistema Digestório/veterináriaRESUMO
A hérnia de hiato esofágico é uma doença que afeta cães e gatos geralmente jovens até um ano de idade como condição hereditária e predisposição racial. O afrouxamento do ligamento frênico esofágico faz com que haja uma projeção de órgãos para dentro do esôfago ou lateralmente a ele. Isso leva ao aparecimento de sinais clínicos inespecíficos e somente com uma adequada anamnese e exame radiográfico detalhado é que se pode concluir que se trata de hérnia de hiato. Relata-se o caso clínico de um cão macho da raça Shar-pei com seis meses de idade, o qual a correção da afecção foi cirúrgica com excelente recuperação do animal(AU)
The hiatal esophagic hernia is a disease that affects generally young dogs and cats up to one year old due to heredity and racial predisposition. The esophagus-frenic ligament weakness makes a projection of organs in to or laterally the esophagus. This fact leads to an appearance of meaning clinical signals and only with a detailed anamnesis and radiographic examination as mean to diagnosing hiatal hernia. This research refers a clinical case of a male dog, Shar-pei that was submitted to surgical treatment. Six months after the surgery, the dog had an excellent recovery(AU)
Assuntos
Animais , Cães , Hérnia Hiatal , Cães , Doenças do Esôfago/veterinária , Hérnia Hiatal/fisiopatologia , Hérnia Hiatal/veterinária , Hérnia Hiatal/cirurgiaRESUMO
A hérnia de hiato esofágico é uma doença que afeta cães e gatos geralmente jovens até um ano de idade como condição hereditária e predisposição racial. O afrouxamento do ligamento frênico esofágico faz com que haja uma projeção de órgãos para dentro do esôfago ou lateralmente a ele. Isso leva ao aparecimento de sinais clínicos inespecíficos e somente com uma adequada anamnese e exame radiográfico detalhado é que se pode concluir que se trata de hérnia de hiato. Relata-se o caso clínico de um cão macho da raça Shar-pei com seis meses de idade, o qual a correção da afecção foi cirúrgica com excelente recuperação do animal
The hiatal esophagic hernia is a disease that affects generally young dogs and cats up to one year old due to heredity and racial predisposition. The esophagus-frenic ligament weakness makes a projection of organs in to or laterally the esophagus. This fact leads to an appearance of meaning clinical signals and only with a detailed anamnesis and radiographic examination as mean to diagnosing hiatal hernia. This research refers a clinical case of a male dog, Shar-pei that was submitted to surgical treatment. Six months after the surgery, the dog had an excellent recovery
Assuntos
Animais , Cães , Cães , Doenças do Esôfago/veterinária , Hérnia Hiatal , Hérnia Hiatal/cirurgia , Hérnia Hiatal/fisiopatologia , Hérnia Hiatal/veterináriaRESUMO
Thoracic radiography of a 3-month-old, female Chinese Shar-pei revealed an esophageal hiatal hernia with stomach, liver, and small intestine displaced into the thorax. Three days after the surgical correction, the dog developed ileal intussusception and was reoperated. Recovery was uncomplicated and the dog was asymptomatic 16 months after surgery.