Esophageal Perforation from Foreign Body

In the Literature

Sterman AA, Mankin KMT, Ham KM, Cook AK. Likelihood and outcome of esophageal perforation secondary to esophageal foreign body in dogs. J Am Vet Med Assoc. 2018;253(8):1053-1056.

The Research …

Esophageal foreign bodies (EFBs) can occur in dogs that have ingested a bone, fishhook, dog treat, or other object. These foreign bodies should be addressed quickly to avoid complications (eg, esophagitis, aspiration pneumonia, stricture, perforation). Treatment typically involves endoscopic removal or dislodging of the EFB to redirect it into the stomach for either digestion or surgical removal.

Records spanning a 9-year period from 2 veterinary schools were retrospectively evaluated for this study. EFBs were identified in 125 dogs. Data from their records were assessed to determine the likelihood of esophageal perforation and to characterize clinical findings, treatment, and outcomes of dogs with EFB.

The most common EFBs detected were bones (44%) and fishhooks (30%). Perforation was diagnosed in 15 (12%) dogs; of these, 10 had a fishhook EFB and 5 had a bone EFB. Overall, dogs with fishhooks were 6.1 times more likely to perforate as compared with dogs with other types of EFB. No association between body weight and perforation was identified.

Endoscopic removal was successful in 90.9% of cases, including 95% of dogs with no perforation. Overall, 6 dogs with perforation of the esophagus required surgical intervention (ie, thoracotomy, exploration of the cervical region); 5 of these had a fishhook EFB.

… The Takeaways

Key pearls to put into practice:

• Radiography followed by endoscopic examination should be a part of the diagnostic investigation in patients with suspected EFBs.

• Owners of dogs with fishhook and bone foreign bodies should be warned of the potential for perforation and need for surgery.

• Timely identification of a foreign body may lead to higher treatment success rates.