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Use the A D current, strong force. Place the N. P., long cord...
Treatment Of Other Eruptive Fevers
The treatment as prescribed for scarlatina in this pamphlet, ...
Stage I Entering The Right Pyriform Sinus
The operator standing (as in Fig. 66), inserts the esophagos...
Breath And Blood
Often difficulty of breathing, especially in close air, mistak...
Endoscopy On The Human Being
Dog work offers but little practice in laryngoscopy. Because...
Abscess Of The Lung
If of foreign-body origin, pulmonary abscess almost invariab...
At the outset, it must ever be remembered that this is not a d...
Of Fungous Ulcer Of The Navel In Infants
It sometimes occurs that a little fungous sore exists upon th...
Telephones And Telephoning
MOST men--and women--use more nervous force in speaki...
NATURE is not only our one guide in the matter of phy...
As the patient should have a constant supply of pure air for ...
Where this is recommended the cold-drawn oil is meant, not the...
The fundamental principles of peroral endoscopy are best tau...
Tricuspid insufficiency, except as rarely found in the fetus,...
Home Methods Of Purifying Water
Boiling. Where the water that you are obliged to drink is not...
Mind In Disease
Often a person, because of physical failure, becomes possessed...
In many cases of severe illness, the stomach rejects all food,...
Often caused by children sucking matches. There is a burning i...
Punctures Case Iii
A female servant punctured the end of the finger by a pin; th...
When a child is suffering after vaccination, we should have hi...
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.
Next: Rupture And Trauma Of The Esophagus
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