Diagnosing disorders of the equine oesophagus

Most disorders of the equine cervical oesophagus present with a similar range of clinical signs, resulting from acute, chronic or recurrent impediment to the transit of ingesta and saliva. These include profuse frothy nasal discharge and dysphagia with gagging and coughing. Rupture of the cervical oesophagus is characterised by a painful ventral swelling at the affected site with crepitus, cellulitis and potential drainage of necrotic material. Disorders of the thoracic and abdominal segments of the oesophagus are less well recognised and clinical signs are more insidious in onset. Catastrophic damage to the thoracic oesophagus may occur without previous signs of obstruction. Pyrexia, tachycardia, tachypnoea and vague colic signs may be the first manifestations of perforation of the thoracic oesophagus, resulting from a progressive septic pleural effusion. Rupture of the thoracic oesophagus should be a differential in any horse presenting with an unexplained pleural effusion and ruled out by careful endoscopic examination.