A case in point is the Benton, Indiana, ghost, which is attracting much attention. It has been seen and investigated by many people with reputations for intelligence and good sense, but so far no explanation of the strange appearance has b... Read more of Some Real American Ghosts The Giant Ghost at Scary Stories.caInformational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Burns Case Xxxv

The following case will present a specimen of my trials of th...

Diet Economy In

Dr. Hutchison, one of our greatest authorities on the subject ...

Inspection Of The Party Wall In Cases Of Suspected Laryngeal Malignancy

When taking a specimen the party wall should be inspected by...

Jaundice

This disease, or its approach, may be known by several signs: ...

Heel Sprained

Often in sprains all attention is given to the bruised and tor...

Choice Of Time To Do Bronchoscopy For Foreign Body

The difficulties of removal usually increase from the time of...

Haemorrhage

See Bleeding; Wounds. ...

Consumption Treatment Of

Turning now to the case when consumption has actually shown it...

Etiology

Rheumatism is the cause of most instances of cardiac disease ...

Modifications Of Electricity

In the present stage of electric science, the conviction has ...

Cramp In The Stomach

This very severe trouble, though resisting ordinary methods of...

Chloroform Or Ether (swallowed)

Emetic; enema of hot coffee; keep awake. If necessary, artific...

Lungs Bleeding From

This is usually taken as a most alarming, and even hopeless, s...

Diet And Corpulence

A tendency to obesity should always be carefully checked by at...

Diet

As intimated in the preceding paragraph, the diet during end...

On The Adherent Eschar

It appears scarcely necessary to describe the immediate and w...

The Surgical Dissection Of The Superficial Structures Of The Male Perinaeum

The median line of the body is marked as the situation where ...

Unconsciousness

There are two opposite causes of unconsciousness. One is conge...

Breathing In Going Uphill

See Breath, and Nerve. British Cholera is to a certain ext...

Filling The Boiler Of The Body-engine

The Need of Water in the Body-Engine. If you have ever taken ...



Differential Diagnosis Of Ulcer Of The Esophagus





Category: DISEASES OF THE ESOPHAGUS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

Simple ulcer requires the exclusion of lues, tuberculosis,
epithelioma, endothelioma, sarcoma, and actinomycosis. Simple ulcer of
the esophagus is usually associated with stenosis, spastic or organic.

Luetic ulcers commonly show a surrounding inflammatory areola, and
they usually have thickened elevated edges, generally free from
granulation tissue, with a pasty center not bleeding readily when
sponged. The Wassermann reaction may contribute to the diagnosis; but
if negative, a thorough and prolonged test with mercury is imperative.
It must be remembered that a person with lues may have a simple,
mixed, or malignant ulceration of the esophagus, or the three lesions
may even be combined. It may be in some cases possible to demonstrate
the treponema pallidum in scrapings taken from the ulcer.

The single tuberculous ulcer is usually pale, superficial, and
granular in base. If it is a continuation from more extensive
extra-esophageal tuberculous ulceration, pale cauliflower granulations
may be present. Slight cicatrices may be seen. Tuberculosis in other
organs can almost always be demonstrated by roentgenographic,
physical, or laboratory studies. Tuberculin tests and animal injection
with an emulsion of a specimen of tissue may be required. The specimen
must be taken very superficially to avoid risk of perforation.

Sarcomatous ulcers do not differ materially in appearance from those
of carcinoma, but they are much more rare.

Carcinomatous ulcer is usually characterized by the very vascular
bright red zone, raised edges, fungations, granulation tissue that
bleeds freely on the lightest touch, and above all, it is almost
invariably situated on an infiltrated base which communicates a
feeling of hardness to the pressure of sponges or the esophagoscope
itself. A scar may be from the healing of an ulcer from stasis, or one
of specific or precancerous character. It may be a cancerous process
developing on the site of a scar, so that the presence of scar tissue
does not absolutely negative malignancy. As a rule, however, scars are
absent in cancer of the esophagus. The firm and sometimes prominent
ridge of the crossing of the left bronchus must not be mistaken for
infiltration, and the esophagoscopist must be familiar with the normal
rigidity of the cricopharyngeus.

[242] Mixed infection gives to all esophageal ulceration a certain
uniformity of appearance, so that laboratory studies of smears or
histologic and bacteriologic study of tissue specimens taken from
fungations or thickened edges are often required to confirm the
endoscopic diagnosis. If the edges are thin and flat, the taking of a
specimen involves some risk; fungations can be removed without risk;
so can nodules, but care must be taken that projecting folds are not
mistaken for nodules. It is always wise to push the therapeutic test
with potassium iodid and especially mercury in any case of esophageal
ulceration unassociated with stasis.





Next: Treatment Of Acute And Subacute Inflammation And Ulceration Of The Esophagus

Previous: Ulceration Of The Esophagus



Add to del.icio.us Add to Reddit Add to Digg Add to Del.icio.us Add to Google Add to Twitter Add to Stumble Upon
Add to Informational Site Network
Report
Privacy
SHAREADD TO EBOOK


Viewed 998