Oesophageal pneumatosis: computed tomographic characteristics in three dogs (2018-2021)

Background: Oesophageal pneumatosis (OP) is defined as the presence of gas within the oesophageal wall. The description of this condition in veterinary medicine is currently lacking. The pathogenesis of alimentary tract pneumatosis remains unclear. Current literature describes that access of gas into the oesophageal wall may occur by one or a combination of the following mechanisms: mucosal disruption, increased intra or extra-luminal pressure or dissection of gas from an extra-oesophageal source. Objectives: The aim of this multi-centric case series was to describe the computed tomography (CT) findings of OP in dogs. Methods: Three adult dogs were included. One dog presented with gastrointestinal signs and general malaise while the other two presented with spontaneous facial and cervical subcutaneous emphysema. Results: CT revealed different degrees of intramural gas along the oesophageal wall in all cases. The first dog was diagnosed with emphysematous gastritis based on the presence of gastric pneumatosis paired with compatible clinicopathological and endoscopic findings. This dog was successfully treated with antibiotics. The remaining two dogs were diagnosed with spontaneous pneumomediastinum and required no surgical or medical treatment. Conclusions: In all cases with OP, there was concurrent gastric pneumatosis. Gas extensively and circumferentially distributed with a banded shape along the oesophageal wall was present in patients with presumed mural gas dissection because of pneumomediastinum. Conversely, a focal and mild amount of mural gas with a tubular shape was identified in the distal segment of the oesophagus in the patient with emphysematous gastritis.