No greater mistake could be made than to curtail the hours of ...
Bathing The Feet
This apparently simple treatment, if the best results are desi...
Scarlatina Anginosa Or Sore-throat Scarlet-fever
Wherever the _throat_ is affected, which is almost always the...
The Glands In The Skin
Sweat Glands. Like all the pavement (epithelial) surfaces of ...
Troubles Of The Nervous System
The Nervous System is not easily Damaged. The nervous system ...
Hurry, Worry, And Irritability
PROBABLY most people have had the experience of hurry...
What is commonly called a "cough and spit" is sometimes due to...
A teaspoonful of lemon juice (freshly expressed), along with h...
Inflammation Of The Bowels
See Bowels. ...
The spinal cord is continuous with the back part of the brain....
Thumb Bruised And Broken
Frequently a tradesman will strike the thumb or finger a serio...
Removal Of Open Safety Pins From The Trachea And Bronchi
Removal of a closed safety pin presents no difficulty if it i...
It should be understood that especially in acute conditions...
The composition of different articles of food varies. A turnip ...
Raw Food Healing Diets
Next in declining order of healing effectiveness is what I ca...
Bandage Four-ply Flannel
The four-ply flannel bandage is simply what its name implies--...
How To Sew Easily
IT is a common saying that we should let our heads sa...
acts favorably on cancers, and is a specific when applied to ...
Length Of Bath
Although the temperature, in sthenic cases, should be a littl...
Diet Economy In
Dr. Hutchison, one of our greatest authorities on the subject ...
Category: 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
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