|VIEW THE MOBILE VERSION of www.homemedicine.ca|| Informational|
Caffein can irritate the heart and cause irregularity and ta...
The Organic Versus Chemical Feud
Now, regrettably, and at great personal risk to my reputation...
NATURE is not only our one guide in the matter of phy...
Deformities Of The Urinary Bladder The Operations Of Sounding For Stone Of Catheterism And Of Puncturing The Bladder Above The Pubes
The urinary bladder presents two kinds of deformity--viz., co...
To Prevent Bilious Fever Or Ague
Take _Podophyllin_, _Baptisia_ and _Gelseminum_ 1st in rotati...
Ulcerative lesions in the larynx during typhoid fever are al...
Accidents And Emergencies
Ordinarily, Accidents are not Serious. Accidents will happe...
No greater mistake could be made than to curtail the hours of ...
Polarization Of The Circuit
I have said, in effect, a little above, that, while the curre...
Punctures Case Ii
Mrs. Middleton, aged 40, wounded her wrist, on the ulnar side...
Chronic postdiphtheritic stenosis may be of the panic, spasm...
This disease is caused by inflammation of the mucous membrane...
At the outset, it must ever be remembered that this is not a d...
Unsuccessful Bronchoscopy For Foreign Bodies
The limitations of bronchoscopic removal of foreign bodies ar...
Practice On The Rubber-tube Manikin
This must be carried out in two ways. 1. General practice...
Emetic; warm coffee, and even an enema of coffee. Artificial r...
The key to action in case of epidemics prevailing in the distr...
These pains occur usually when a patient has been for some tim...
The spinal cord is continuous with the back part of the brain....
A most common trouble is anaemia, a lack of good red blood, sh...
Extraction Of Open Safety-pins From The Esophagus
Category: ESOPHAGOSCOPY FOR FOREIGN BODY
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
An open safety
pin with the point down offers no particular mechanical difficulty in
removal. Great care must be exercised, however, that it be not
overridden or pushed upon, as either accident might result in
perforation of the esophagus by the pin point. The coiled spring is to
be sought, and when found, seized with the rotation forceps and the
pin thus drawn into the esophagoscope to effect closure. An open
safety-pin lodged point upward in the esophagus is one of the most
difficult and dangerous problems. A roentgenogram should always be
made in the plane showing the widest spread of the pin. It is to be
remembered that the endoscopist can see but one portion of the pin at
a time (except in cases of very small safety-pins) and that if he
grasps the part first showing, which is almost invariably the keeper,
fatal trauma will surely be inflicted when traction is made. It may be
best to close the safety pin with the safety-pin closer, as
illustrated in Fig. 37. For this purpose Arrowsmith's closer is
excellent. In other cases it may prove best to disengage the point of
the pin and to bring the pointed shaft into the esophagoscope with the
Tucker forceps and withdraw the pin, forceps, and esophagoscope, with
the keeper and its shaft sliding alongside the tube. The rounded end
of the keeper lying outside the tube allows it to slip along the
esophageal walls during withdrawal without inflicting trauma; however,
should resistance be felt, withdrawal must immediately cease and the
pin must be rotated into a different plane to release the keeper from
the fold in which it has probably caught. The sense of touch will aid
the sense of sight in the execution of this maneuver (Fig. 87). When
the pin reaches the cricopharyngeal level the esophagoscope, forceps,
and pin should be turned so that the keeper will be to the right, not
so much because of the cricopharyngeal muscle as to escape the
posteriorly protuberant cricoid cartilage. In certain cases in which
it is found that the pointed shaft of a small safety pin has
penetrated the esophageal wall, the pin has been successfully removed
by working the keeper into the tube mouth, grasping the keeper with
the rotation forceps or side-curved forceps, and pulling the whole pin
into the tube by straightening it. This, however, is a dangerous
method and applicable in but few cases. It is better to disengage the
point by downward and inward rotation with the Tucker forceps.
Next: Version Of A Safety Pin
Previous: Mechanical Problems Of Esophagoscopic Removal Of Foreign Bodies