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Inspection of the hypopharynx and upper esophagus is readily...
Other Forms Of Rest
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Endocarditis A Secondary Affection
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Bronchoscopic Appearances In Disease
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Ankle Twisted Or Crushed
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The Confusions About Diets And Foods
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The Dissection Of The Oblique Or External And The Direct Or Internal Inguinal Herniae
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The Surgical Dissection Of The Deep Structures Of The Male Perinaeum The Lateral Operation Of Lithotomy
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Aortic Stenosis Aortic Obstruction
Valvular disease at the aortic orifice is much less common th...
Mechanical Problems Of Bronchoscopic Foreign Body Extraction*
* For more extensive consideration of mechanical problems...
Painful Urination Incontinence Of Urine
_Involuntary Urination._ Where the discharge of urine prod...
Troubles Of The Nervous System
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Cramp In The Stomach
This very severe trouble, though resisting ordinary methods of...
Anomalies Of The Esophagus
Category: DISEASES OF THE ESOPHAGUS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Congenital esophagotracheal fistulae are the most frequent of the
embryonic developmental errors of this organ. Septic pneumonia from
the entrance of fluids into the lungs usually causes death within a
Imperforate esophagus usually shows an upper esophageal segment
ending in a blind pouch. A lower segment is usually present and may be
connected with the upper segment by a fistula.
Congenital stricture of the esophagus may be single or multiple, and
may be thin and weblike, or it may extend over a third or more of the
length of the esophagus. It may not become manifest until solids are
added to the child's diet; often not for many months. The lodgment of
an unusually large bolus of unmasticated food may set up an
esophagitis the swelling of which may completely close the lumen of
the congenitally narrow esophagus. It is not uncommon to meet with
cases of adults who have never swallowed as well as other people,
and in whom cicatricial and spasmodic stenosis can be excluded by
esophagoscopy, which demonstrates an obvious narrowing of the
esophageal lumen. These cases are doubtless congenital.
Webs in the upper third of the esophagus are best determined by the
passage of a large esophagoscope which puts the esophagus on the
stretch. The webs may be broken by the insertion of a closed alligator
forceps, which is then withdrawn with opened blades. Better still is
the dilator shown in Fig. 26. This retrograde dilatation is relatively
safe. A silk-woven esophagoscopic bougie or the metallic tracheal
bougie may be used, with proper caution. Subsequent dilatation for a
few times will be required to prevent a reproduction of the stenosis.
Treatment of Esophageal Anomalies.--Gastrostomy is required in the
imperforate cases. Esophagoscopic bouginage is very successful in the
cure of all cases of congenital stenosis. Any sort of lumen can be
enlarged so any well masticated food can be swallowed. Careful
esophagoscopic work with the bougies (Fig. 40) will ultimately cure
with little or no risk of mortality. Any form of rapid dilatation is
dangerous. Congenital stenosis, if not an absolute atresia, yields
more readily to esophagoscopic bouginage than cicatricial stenosis.
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