VIEW THE MOBILE VERSION of www.homemedicine.ca Informational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

On The Adherent Eschar

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

Paralysis

Bilateral abductor laryngeal paralysis causes severe stenosi...

Indications For Strychnin

Strychnin is a much overused drug. It is now given for almost...

Blood Purifying

Fever arising from bad state of the blood may be treated by ca...

Paroxysmal Tachycardia Management

There is no specific treatment for paroxysmal tachycardia. Wh...

Plate V Laryngeal And Tracheal Stenoses:

1, Indirect view, sitting position; postdiphtheric cicatricia...

Direct Laryngoscopy Adult Patient

Before starting, every detail in regard to instrumental equi...

Chronic Myocarditis Fibrous

Chronic myocarditis may develop on an acute myocarditis, but ...

Facts

In 1845-46 there was an epidemic in Dresden, a city of 100,00...

Auricular Fibrillation Treatment

The condition may be stopped by relieving the heart and circu...

Starches

Sources of Starch. The starches are valuable and wholesome fo...

The Surgical Dissection Of The Superficial Bloodvessels Etc Of The Inguino-femoral Region

Hernial protrusions are very liable to occur at the inguino-f...

Sunshine

Is a most valuable aid to health, acting as a physical and men...

Symptoms Of Gastric Foreign Body

Foreign body in the stomach ordinarily produces no symptoms. ...

Mechanical Problems Of Esophagoscopic Removal Of Foreign Bodies

The bronchoscopic problems considered in the previous chapter...

Cold Taking

Where cold is easily "taken," it is the skin which is defectiv...

Indigestion

(See also Digestion; Assimilation.) This subject leads natural...

Blisters

The destruction of the skin over any painful part, by means of...

Haemorrhoids Piles

If the case be recent, take the B D current; if old, take A D...

Diagnosis

If a more malignant form of endocarditis develops on a mild ...



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 Informational Site Network
Report
Privacy
ADD TO EBOOK


Viewed 1850