Overview

• Pouch-like sacculations of the esophageal wall that accumulate fluids and ingesta.
• Diverticula may be congenital or acquired and are rare.
• Pulsion diverticula occur secondary to increased intraluminal pressure. Seen with esophageal obstructive disorders such as foreign body or mass lesions.
• Traction diverticula occur secondary to periesophageal inflammation where fibrosis and contraction pull out the wall of the esophagus into a pouch.
• Diverticuli most commonly occur at the thoracic inlet or near the hiatus.
• Organ systems affected include the gastrointestinal (regurgitation), musculoskeletal (weight loss), and respiratory (aspiration pneumonia).

Signalment

• Rare; more common in dog than cat
• Congenital or acquired (no genetic basis proven)
• No important breed or sex predisposition

Signs

• Postprandial regurgitation, dysphagia, anorexia, coughing
• Weight loss, respiratory distress

Causes & Risk Factors

Differential Diagnosis

CBC/Biochemistry/Urinalysis

Usually within normal limits

Other Laboratory Tests

N/A

Imaging

• Thoracic radiography-may show air or soft tissue opacity cranial to the diaphragm or cranial to the thoracic inlet.
• Contrast esophagram-shows contrast accumulation within the diverticulum.
• Videofluoroscopy-useful to evaluate for disturbances in esophageal motility.

Diagnostic Procedures

Esophagoscopy confirms ingesta/debris within outpouchings of the esophagus.

Drug(s)

• Drug therapy for esophagitis, if present.
• Give H₂ histamine antagonists (e.g., ranitidine 2 mg/kg PO q12h or famotidine 0.5–1 mg/kg PO q12h) if the patient has concurrent esophagitis.
• Proton pump inhibitors such as omeprazole are more potent and effective antacids than the H₂ histamine antagonists for management (0.7–1.5 mg/kg PO q24h) of severe esophagitis.
• Use broad-spectrum antibiotics if the patient has concurrent aspiration pneumonia; if severe pneumonia is present, base antibiotic selection on culture and sensitivity of samples obtained by transtracheal wash or bronchoalveolar lavage.

Contraindications/Possible Interactions

N/A

Patient Monitoring

• Evaluate for evidence of infection or aspiration pneumonia.
• Maintain positive nutritional balance throughout disease process.

Possible Complications

Patients with diverticula and impaction are predisposed to perforation, fistula, stricture, and postoperative incisional dehiscence.

Expected Course and Prognosis

Prognosis is guarded in patients with large diverticula and overt clinical signs.

Internet Resources

Veterinary Information Network: www.vin.com/VIN.plx.