Presentation
Epigastric pain.
Patient Data
Spot radiograph from a double contrast oesophagram.
There are numerous 1-2 mm radiolucent folds across the oesophagus. The folds are angled with respect to the centre of the oesophagus in a "herringbone" pattern.
The folds occur transiently.
Case Discussion
Feline oesophagus appears when the oesophagus contracts longitudinally and the term arises from its supposed similarity to the appearance of cat oesophageal motion (congratulations to those who dare to perform esophagrams on fanged mammals). The appearance has also been termed "oesophageal shiver", which may be a better name since it implies that the oesophagus is reacting to a semi-noxious stimulus. Thanks to Liz Chorney, MD for capturing this at just the right moment.
The main importance of recognising this sign is twofold:
- so as not to mistake it for something more serious, e.g.
- linear scarring (fixed "stepladder" scarring) in chronic reflux oesophagitis
- the thicker folds of eosinophilic oesophagitis
- to recognise that it is very tightly correlated with gastro-oesophageal reflux (Ref. 2)
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