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Diffuse Dilatation Of The Esophagus
Category: DISEASES OF THE ESOPHAGUS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
This is practically always due to stagnation ectasia, which is
invariably associated with either organic or spasmodic stricture,
existing at the time of observation or at some time prior thereto. The
dilating effect of the repeatedly accumulated food results in a
permanent enlargement, so that the esophagus acts as the reservoir of
a large funnel with a very small opening. When food is swallowed the
esophagus fills, and the contents trickle slowly through the opening.
Gases due to fermentation increase the distension and cause substernal
pressure, discomfort, and belching. A very large dilatation of the
thoracic esophagus indicates spastic stenosis. Cicatricial stenoses do
not result in such large dilatations and the dilatation above a
malignant stenosis is usually slight, probably because of its
relatively shorter duration.
The treatment of diffuse esophageal dilatation consists in dilating
the diaphragmatic pinchcock that is, the hiatal esophagus. Chronic
esophagitis is to be controlled by esophageal lavage, the regulation
of the diet to liquefiable foods and the administration of bismuth
subnitrate. The patient can be taught to do the lavage. The local
esophagoscopic application of a small quantity of a 25 per cent watery
solution of argyrol may be required for the static esophagitis. The
redundancy probably never disappears; but functional and subjective
cures are usually obtainable.
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