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

The Inward And The Outward Current

I have already said that when the conducting-cords are of equ...

Running The Human Automobile

The Body-Automobile. If you were to start to-morrow morning...

Punctures Case X

Mr. Worth's daughter, aged six, was thrown down by a dog and ...

Nerves Troubled

Often a state of the nerves exists, without any apparent unhea...

Fever Scarlet Or Scarlatina

As a first precaution, when an epidemic of this exists, childr...

Papillomata Of The Larynx In Children

Of all benign growths in the larynx papilloma is the most fre...

Gout

Some have a predisposition to this most painful disease, and r...

The Throat Should Be Covered With A Wet Compress I E A Piece Of

linen four to eightfold, according to its original thickness, d...

Relaxation Of Treatment Towards The End Of The Third Period Continuation Of Packs During And After Desquamation

When the patient is through the first part of the period of ...

Neck Twisted

This arises from the undue contraction of some of the muscles ...

Pericarditis Symptoms And Signs

If there is pain or much aching in the cardiac region, it ten...

Kidney Complaints

See Urinary Troubles. ...

Of Fungous Ulcer Of The Navel In Infants

It sometimes occurs that a little fungous sore exists upon th...

Mustard Oil

Where this is recommended the cold-drawn oil is meant, not the...

Ventilation All-important

If the circulation of air is necessary in any other form of ...

Extent Of Electric Agency

When we have settled upon the position that the electricity o...

Bruises Case Xvii

An old man, aged 60, received a bruise upon the occiput from ...

Ankle Swelling

When long continued in connection with disease or accident, th...

Inflammation Deep-seated

Often inflammation occurs in the centre of, or beneath, a mass...

Eruptions

See Hives; "Outstrikes;" Saltrome, etc. ...



Paralysis Of The Esophagus





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

The passage of liquids and solids through the esophagus is a purely
muscular act, controlled, after the propulsive usually voluntary start
given to the bolus by the inferior constrictor, by a reflex arc having
connection with the central nervous system through the vagus nerve.
Gravity plays little or no part in the act of deglutition, and alone
will not carry food or drink to the stomach. Paralysis of the
esophagus may be said to be motor or sensory. It is rarely if ever
unassociated with like lesions of contiguous organs.

Motor paralysis of the esophagus is first manifested by inability to
swallow. This is associated with the accumulation of secretion in the
pyriform sinuses (the author's sign of esophageal stenosis) which
overflows into the larynx and incites violent coughing. Motor
paralysis may affect the constrictors or the esophageal muscular
fibers or both.

Sensory paralysis of the esophagus by breaking the continuity of the
reflex arc, may so impair the peristaltic movements as to produce
aphagia. The same filling of the pyriform sinuses will be noted, but
as the larynx is usually anesthetic also, it may be that no cough is
produced when secretions overflow into it.

Etiology.--1. Toxic paralysis as in diphtheria.
2. Functional paralysis as in hysteria.
3. Peripheral paralysis from neuritis.
4. Central paralysis, usually of bulbar origin.
Embolism or thrombosis of the posterior cerebral artery is a
reported cause in two cases. Lues is always to be excluded as the
fundamental factor in the groups 3 and 4. Esophageal paralysis is not
uncommon in myasthenia gravis.

Esophagoscopic findings are those of absence of the normal
resistance at the cricopharyngeus, flaccidity and lack of sensation of
the esophageal walls, and perhaps adherence of particles of food to
the folds. The hiatal contraction is usually that normally
encountered, for this is accomplished by the diaphragmatic
musculature. In paralysis of sensation, the reflexes of coughing,
vomiturition and vomiting are obtunded.

Diagnosis.--Hysteria must not be decided upon as the cause of
dysphagia, until after esophagoscopy has eliminated paralysis.
Dysphagia after recent diphtheria should suggest paralysis of the
esophagus. The larynx, lips, tongue, and pharynx also, are usually
paralyzed in esophageal paralysis of bulbar origin. The absence of the
cricopharyngeal resistance to the esophagoscope passed without
anesthesia, general or local, is diagnostic.

Treatment.--The internist and neurologist should govern the basic
treatment. Nutrition can be maintained by feeding with the
stomach-tube, which meets no resistance to its passage. Should this be
contraindicated by ulceration of the esophagus, gastrostomy should be
done.





Next: Lues Of The Esophagus

Previous: Diverticulum 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