|Once upon a time, there was a Rat Princess, who lived with her father, the Rat King, and her mother, the Rat Queen, in a ricefield in far away Japan. The Rat Princess was so pretty that her father and mother were quite foolishly proud of he... Read more of THE RAT PRINCESS at Children Stories.ca|| Informational|
Medical ArticlesHow And Why We Breathe
Life is Shown by Breathing. If you wanted to find out whether...
This is an affection of the bowels of the nature of diarrhoea,...
Conclusive Remarks Obstacles
Before concluding my article, I shall attempt to remove a few...
How the Nails are Made. Another trade, which our wonderful sk...
Small Pox - Variola
This disease begins with pain in the head and back, chilly se...
Ears Singing In The
Partial deafness is often accompanied by noises in the ear, wh...
Why People Get Sick
This is the Theory of Toxemia. A healthy body struggles conti...
Decannulation after tracheotomy done for papillomata should ...
Rheumatism is the cause of most instances of cardiac disease ...
Dr Jerome Kidder's Electro-magnetic Machine
On opening the machine-box, as it comes from the manufacturer...
To Prevent Cholera
_Camphor_ (_pellets medicated_ with the pure tincture) _Verat...
Length Of The Fast
How long should a person fast? In cases where there are serio...
Aphonia Loss Of Voice
This affection requires treatment variously, as it depends on...
Deformities Of The Prostate Distortions And Obstructions Of The Prostatic Urethra
The prostate is liable to such frequent and varied deformitie...
Introduction Of The Bronchoscope
No one should do bronchoscopy until he is able to expose the ...
Strabismus Discordance Of The Eyes
If neither of the rectus muscles have been cut and cicatrized...
The Malignant Forms Of Scarlet-fever
are caused by the character of the epidemy, but, perhaps, mor...
Tuberculosis Of The Tracheobronchial Tree
The bronchoscopic study of tuberculosis is very interesting,...
Rules For Direct Laryngoscopy
1. The laryngoscope must always be held in the left hand, nev...
See Rubbing. ...
Extraction Of Tacks Nails And Large Headed Foreign Bodies From The Tracheobronchial Tree
Category: MECHANICAL PROBLEMS OF BRONCHOSCOPIC FOREIGN BODY EXTRACTION
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
In cases of this sort the point presents the
same difficulty and requires solution in the same manner as mentioned
in the preceding paragraphs on the extraction of pins. The author's
inward-rotation method when executed with the Tucker forceps is ideal.
The large head, however, presents a special problem because of its
tendency to act as a mushroom anchor when buried in swollen mucosa or
in a fibrous stenosis (Fig. 83). The extraction problems of tacks are
illustrated in Figs. 84, 85, and 86. Nails, stick pins, and various
tacks are dealt with in the same manner by the author's inward
Hollow metallic bodies presenting an opening toward the observer may
be removed with a grooved expansile forceps as shown in Figs 23 and
25, or its edge may be grasped by the regular side-grasping forceps.
The latter hold is apt to be very dangerous because of the trauma
inflicted by the catching of the free edge opposite the forceps; but
with care it is the best method. Should the closed end be uppermost,
however, it may be necessary to insert a hook beyond the object, and
to coax it upward to a point where it may be turned for grasping and
removal with forceps.
[FIG. 83.--Mushroom anchor problem of the upholstery tack. If the
tack has not been in situ more than a few weeks the stenosis at the
level of the darts is simply edematous mucosa and the tack can be
pulled through with no more than slight mucosal trauma, provided
axis-traction only be used. If the tack has been in situ a year or
more the fibrous stricture may need dilatation with the divulsor.
Otherwise traction may rupture the bronchial wall. The stenotic tissue
in cases of a few months' sojourn maybe composed of granulations, in
which case axis-traction will safely withdraw it. The point of a tack
rarely projects freely into the lumen as here shown. More often it is
buried in the wall.]
 [FIG. 84.-Schema illustrating the mushroom anchor problem of
the brass headed upholstery tack. At A the tack is shown with the head
bedded in swollen mucosa. The bronchoscopist, looking through the
bronchoscope, E, considering himself lucky to have found the point of
the tack, seizes it and starts to withdraw it, making traction as
shown by the dart in drawing B. The head of the tack catches below a
chondrial ring and rips in, tearing its way through the bronchial wall
(D) causing death by mediastinal emphysema. This accident is still
more likely to occur if, as often happens, the tack-head is lodged in
the orifice of the upper lobe bronchus, F. But if the bronchoscopist
swings the patient's head far to the opposite side and makes
axis-traction, as shown at C, the head of the tack can be drawn
through the swollen mucosa without anchoring itself in a cartilage. If
necessary, in addition, the lip of the bronchoscope can be used to
repress the angle, h, and the swollen mucosa, H. If the swollen
mucosa, H, has been replaced by fibrous tissue from many months'
sojourn of the tack, the stenosis may require dilatation with the
[FIG. 85.--Problem of the upholstery tack with buried point. If pulled
upon, the imminent perforation of the mediastinum, as shown at A will
be completed, the bronchus will be torn and death will follow even if
the tack be removed, which is of doubtful possibility. The proper
method is gently to close the side curved forceps on the shank of the
tack near the head, push downward as shown by the dart, in B, until
the point emerges. Then the forceps are rotated to bring the point of
the tack away from the bronchial wall.]
Next: Removal Of Open Safety Pins From The Trachea And Bronchi
Previous: Inward Rotation Method