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Feline esophagus

Case contributed by Dr Matt A. Morgan

Presentation

Epigastric pain.

Patient Data

Age: 55-60
Gender: Female
Barium

Spot radiograph from a double contrast oesophagram.

There are numerous 1-2 mm radiolucent folds across the esophagus. The folds are angled with respect to the center of the esophagus in a "herringbone" pattern. 

The folds occur transiently.

Case Discussion

Feline esophagus appears when the esophagus contracts longitudinally and the term arises from its supposed similarity to the appearance of cat esophageal motion (congratulations to those who dare to perform esophagrams on fanged mammals). The appearance has also been termed "esophageal shiver", which may be a better name since it implies that the esophagus is reacting to a semi-noxious stimulus. Thanks to Liz Chorney, MD for capturing this at just the right moment.

The main importance of recognizing this sign is twofold:

  • so as not to mistake it for something more serious, e.g.
    • linear scarring (fixed "stepladder" scarring) in chronic reflux esophagitis
    • the thicker folds of eosinophilic esophagitis
  • to recognize that it is very tightly correlated with gastro-esophageal reflux (Ref. 2)

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