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Medical ArticlesBiliary Calculi Gravel In LiverTake A C current, strong as can be borne; and treat the infla... Bile Black For this take two tablespoonfuls of hot water every five minut... Physics Of Mitral Stenosis Mitral stenosis, though less common than mitral regurgitation... Bone Soft Often, in the young, the bones are so soft that they bend more... Perspiration By this term we mean not only the sensible perspiration which ... Pathology If the foreign body completely obstructs a main bronchus, pr... Pulsus Alternans By this term is meant that condition of pulse in which, thoug... Head Skin Of The The nerves of sensibility are very largely supplied to the ski... The Throat Should Be Covered With A Wet Compress I E A Piece Of linen four to eightfold, according to its original thickness, d... Pneumonia Its Cause and Prevention. The other great disease of the lung... Bathing The Feet This apparently simple treatment, if the best results are desi... Prussic Acid Almost hopeless. Emetic; artificial respiration. ... Blood A most common trouble is anaemia, a lack of good red blood, sh... Practice On The Dog Having mastered the technic of introduction on the cadaver a... The Dissection Of The Oblique Or External And The Direct Or Internal Inguinal Herniae The order in which the herniary bowel takes its investments f... Spine Weakness Of The See Children's Healthy Growth. ... Affection Of The Brain When the _brain_ is affected, the patient suddenly complains ... Urinary Troubles A healthy man usually evacuates about 30-40 ozs. of urine dail... The Surgical Dissection Of The Superficial Structures Of The Male Perinaeum The median line of the body is marked as the situation where ... Opium See Narcotics. ... |
ContraindicationsCategory: ESOPHAGOSCOPY FOR FOREIGN BODY Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery There is no absolute contraindication to careful esophagoscopy for the removal of foreign bodies, even in the presence of aneurism, serious cardiovascular disease, hypertension or the like, although these conditions would render the procedure inadvisable. Should the patient be in bad condition from previous ill-advised or blind attempts at extraction, endoscopy should be delayed until the traumatic esophagitis has subsided and the general state improved. It is rarely the foreign body itself which is producing these symptoms, and the removal of the object will not cause their immediate subsidence; while the passage of the tube through the lacerated, infected, and inflamed esophagus might further harm the patient. Moreover, the foreign body will be difficult to find and to remove from the edematous and bleeding folds, and the risk of following a false passage into the mediastinum or overriding the foreign body is great. Water starvation should be relieved by means of proctoclysis and hypodermoclysis before endoscopy is done. The esophagitis is best treated by placing dry on the tongue at four-hour intervals the following powder: Rx. Anesthesin...gramme 0.12 Bismuth subnitrate...gramme 0.6 Calomel, gramme 0.006 to 0.003 may be added to each powder for a few doses to increase the antiseptic effect. If the patient can swallow liquids it is best to wait one week from the time of the last attempt at removal before any endoscopy for extraction be done. This will give time for nature to repair the damage and render the removal of the object more certain and less hazardous. Perforation of the esophagus by the foreign body, or by blind instrumentation, is a contraindication to esophagoscopy. It is manifested by such signs as subcutaneous emphysema, swelling of the neck, fever, irritability, increase in pulsatory and respiratory rates, and pain in the neck or chest. Gaseous emphysema is present in some cases, and denotes a dangerous infection. Esophagoscopy should be postponed and the treatment mentioned at the end of this chapter instituted. After the subsidence of all symptoms other than esophageal, esophagoscopy may be done safely. Pleural perforation is manifested by the usual signs of pneumothorax, and will be demonstrated in the roentgenogram. Next: Esophagoscopic Extraction Of Foreign Bodies Previous: Indications
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