Esophageal Stricture

Allison Zwingenberger

University of California Davis

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Publication Date: 2007-03-26

Patient

History

10 yr female neutered domestic short haired cat with trouble swallowing.

Recently diagnosed with Hemobartonella and treated with doxycycline.

Findings

Plain radiographs were unremarkable. Fluoroscopy was performed using liquid barium. There was a persistent narrowing in the cranial cervical esophagus which never dilated as the peristaltic bolus passed through it. There was also slowing of the bolus passage at this site.

Diagnosis

Esophageal stricture secondary to doxycycline toxicity.

Discussion

Strictures often cause a chronic partial obstruction of the esophagus. Common causes are gastric reflux under anesthesia, vomiting, foreign bodies and caustic agents. There are reports of doxycycline capsules being retained in the esophagus of cats and causing localized necrosis and evantual scarring with stricture.

Plain radiographs are often normal in these cases, and contrast radiography and fluoroscopy are required. Liquid barium may reveal a stricture with radiography if the timing is correct. Fluoroscopy is ideal to watch the passage of contrast throughout the length of the esophagus. Barium soaked kibble is a good second step after liquid barium, as moderate strictures are often well delineated.