Migration of a gastric bezoar to esophagus: A rare cause of acute dysphagia

Sudden onset of dysphagia due to a gastric bezoar migrating to the esophagus is a relatively rare condition. A 72-year-old male patient with known gastric bezoar presented with sudden difficulty swallowing following nausea and vomiting caused by adhesive ileus. Gastroscopic examination showed a bezoar and associated compression ulcers in the esophagus. The bezoar was pushed towards the stomach and extracted by successful endoscopic fragmentation.

A preli­minary study of endoscopic diagnosis of gastric ulcer in Egyptian donkeys (Equus asinus) pa­ra­sitised by Gasterophilus intestinalis (Diptera: Oestridae)

Equine gastric ulcer syndrome (EGUS) is a communal broad problem in equines but in donkeys, the disease is a subclinical disorder which leads to economic losses. Gasterophilus intestinalis larvae are the most predominant parasitic infestation in donkeys. The present study was planned to facilitate the early and efficient diagnosis of gastric ulceration in donkeys through gastroscopic examination. The study was conducted on 120 adult Egyptian donkeys (Equus asinus) from both sexes after a one-month acclimatisation period. Gastroscopic examination was used to evaluate the presence of gastric lesions. In the majority of infested donkeys, G. intestinalis larvae were in the non-glandular part of the stomach. The prevalence of Gastrophilus larvae in animals reached 96.66%. The infestation percentage among jennets (97.5%) was slightly higher than that among jacks (96.25%). After morphological identification of the 3rd instar of larvae, all donkeys were found to be infested by G. intestinalis larvae. The histopathological examination of the affected stomach revealed severe necrosis of the gastric mucosa. Gastroscopic examination is the main diagnostic tool for examination of gastric lesions in the donkeys, so it is necessary as a routine diagnostic tool in donkeys’ examinations.

Clinical management of gastroduodenitis and equine gastric ulcer syndrome grade IV of unknown origin in an Arabian mare

A two-year-old Arabian filly was referred with symptons of colic. Clinical examination revealed signs associated with endotoxemia. Ultrasonographic examination of the abdomen demonstrated severe distention of the stomach and distended loops of small intestine with reduced motility. With nasogastric intubation, eight liters of hemorrhagic reflux were retrieved. Gastroscopic examination showed a severe degree of gastric ulceration scored as equine gastric ulcer syndrome (EGUS) grade IV. Based on these findings, EGUS and gastroduodenitis (GD) were diagnosed. Initially, the horse was treated using parenteral pantoprazole, which was supplemented by adding enteral ranitidine and sucralfate when the horse ceased refluxing. The horse was discharged eleven days after presentation with a 75%-healing of the gastric ulcers. A control gastroscopic examination was performed thirty days after discharge showing a 90%-healing (EGUS Grade I). To the authors’ knowledge, this is the first case report in which pantoprazole in combination with ranitidine and sucralfate has been used to treat a severe degree of gastric ulceration.