Imaging Sciences Interesting Cases
Case 26
Daniel Ginat, MD
Clinical Presentation: The patient is a 41-year-old female with dysphagia for 6 months.
Imaging Findings: The patient was administered barium orally. Images of the esophagus and upper stomach were obtained in AP and oblique views followed by standard overhead radiographs.
Single-contrast examination of the esophagus demonstrates feline esophagus and secondary esophageal folds indicative of esophagitis. There is a small hiatal hernia. No gastroesophageal reflux was observed during the study. There is suggestion of a small Schatzki ring.
Figure 1: Numerous fine transverse striations coated with barium in the distal esophagus are characteristic of feline esophagus (within blue circle). Small Schatzki ring is present in small, contrast-filled sliding hiatal hernia.
Diagnosis: Feline Esophagus in the Context of Esophagitis
Discussion: Similar to the findings described on tantalum esophagrams performed on cats, feline esophagus denotes numerous fine transverse muscosal lines that typically encircle the esophageal lumen. These features can be demonstrated on barium esophagography and endoscopy. Although it is considered a normal variant produced by transient contraction of the muscularis mucosa, it may be associated with esophagitis.
Main differential considerations include chronic reflux esophagitis transverse folds and tertiary contractions. However, the transverse folds of reflux esophagitis tend to be fixed, broad and short. Likewise, tertiary contractions produce single or multiple broad transverse bands that are nonpropulsive in nature.
Feline esophagus is of little clinical significance and does not exhibit age or gender predominance.References:
- Johnson CD, Schmit GD. Mayo Clinic Gastrointestinal Imaging Review. Mayo Clinic Scientific Press, 2005, page 52.
- Furth EE, Rubesin SE, Rose D. Feline esophagus. AJR Am J Roentgenol. 1995 Apr;164(4):900. [PubMed]
- Kundrotas LW, Young GS, Lang KA, Woods JA. Felinization of the esophagus. Gastrointest Endosc. 1995 Jul;42(1):37-40. [PubMed]