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. 2020 Jun 2;15(6):e0233983.
doi: 10.1371/journal.pone.0233983. eCollection 2020.

Oesophageal foreign bodies in cats: Clinical and anatomic findings

Naglaa A Abd Elkader  1 , Ibrahim A Emam  1 , Haithem A Farghali  1 , Daghash S M  2 , Noha Y Salem  3
Affiliations

Oesophageal foreign bodies in cats: Clinical and anatomic findings

Naglaa A Abd Elkader et al. PLoS One. .

Abstract

Background: Anatomical feline models can aid in understanding the relationships between clinical findings and anatomical features and the course of foreign bodies passing through the oesophagus. This study has two goals 1) to assess feline oesophageal foreign bodies in feline patients using physical, radiologic and endoscopic examination and, how their location influences treatment plans and complications. 2) How the anatomical sharp angle of the oesophagus contribute to foreign body lodgement. Thirty-five cats were enrolled in this study; 30 of them were clinically ill, and five cats were used for anatomical study.

Results: Cats with clinical signs underwent complete clinical and radiologic examination. Endoscopy was performed in only five cases. The site with the highest occurrence of foreign body lodgement was the oesophageal entrance, caudal to the pharynx (63.3%), followed by the thoracic inlet (26.7%) and the mid-cervical region of the oesophagus (10%). Two types of foreign bodies were identified: sewing needles (25/30) and bone (5/30). Radiography was able to identify the location and nature of the foreign body in all 30 affected cats. Therapeutic regimens were applied according to the nature and location of the foreign body and any associated complications. Removal of the foreign body was achieved using Rochester pean artery forceps in 17/30 cases, using full surgical intervention in 8/30 cases, and during endoscopy in 5/30 cases.

Conclusion: The results suggest that the location of the foreign body is strongly related to combination of consumed foreign body type and anatomic features of the cat oesophagus. The feline oesophagus has a variety of sharp angles that facilitate the entrapment of rigid linear and angular foreign bodies. Radiographic imaging remains the most frequently used diagnostic modality for determining the lodgement site and nature of radiopaque foreign bodies. Over all complication rate was low (6/30).

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Clinical and radiographic findings regarding oesophageal foreign bodies at the oesophageal entrance (cervical region).
a. Clinical photograph of mixed breed cat showing protruded sewing needle in oral cavity. b. Lateral radiographic view of cat showing radiopaque needle.
Fig 2
Fig 2. Complications of foreign bodies in the area of the oesophageal entrance (cervical region of the oesophagus caudal to pharynx).
a. Photographic picture showing passing of needle and attached thread in epiglottis. b. Lateral radiographic view of cat showing radiopaque needle barrelled to oesophagus (black arrow). c. Photographic picture showing needle (black arrow) passing through oesophageal wall and forming abscess. d. Photographic picture showing small abscess at the level of the cervical oesophagus (black arrow).
Fig 3
Fig 3. Radiographic and endoscopic views of foreign bodies in the mid-cervical oesophagus.
a. Lateral radiographic view showing radiopaque bone structure in the cervical region of the oesophagus. b. Lateral radiographic view showing radiopaque bone fragments in the mid-cervical region of the oesophagus. c. Oesophagoscopy showing bone in the cervical region of the oesophagus. d. Bone after retrieval.
Fig 4
Fig 4. Foreign body lodgement at the thoracic inlet.
a. Lateral radiographic view showing penetrating needle at the level of the thoracic inlet. b. Lateral radiographic view showing radiopaque needle with soft tissue abscessation from the axilla to the mammary glands. c. Removal of a needle with its suture material from the pectoral muscles.
Fig 5
Fig 5
Dissected fixed cat, left side; the course of the entire oesophagus is shown.
Fig 6
Fig 6. Negative contrast radiograph of a cat oesophagus.
a) Left lateral view of a negative contrast radiograph of a cat oesophagus, showing its anatomy (visible Trachea). b) Left lateral view of a negative contrast radiograph of a cat oesophagus, showing its anatomy (visible Abdominal oesophagus and thoracic aorta).
Fig 7
Fig 7. Ventro-dorsal view of a barium-filled catheter radiograph of a cat oesophagus, showing its anatomy.
Fig 8
Fig 8. Kemapoxy 150 green-coloured corrosion cast of the oesophagus and stomach showing the main deviations of the oesophagus.
Fig 9
Fig 9. Dissected fixed cat, left side, with opened oesophageal hiatus in the diaphragm showing the terminal part of the oesophagus.
See this image and copyright information in PMC

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