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

Tetanus

This is substantially the same thing as trismus, except that ...

The Relative Anatomy Of The Male Pelvic Organs

As the abdomen and pelvis form one general cavity, the organs...

Fruits And Vegetables

The Special Uses of Fruits and Vegetables. We come now to t...

Positive And Negative Effort

DID you ever have the grip? If you ever have you may ...

The Temperature Of The Room However Should Be A Few Degrees

higher than in scarlatina, as none of these other eruptive dise...

Feeding Over

It is well to remember that over-feeding is a relative term. T...

Heat And Weakness

We have over and over again shown in these papers how heat pas...

Healing-spells In Ancient Times

Neither doth fansy only cause, but also as easily cure ...

Operating Room

All endoscopic procedures should be performed in a somewhat ...

The Form Of The Thoracic Cavity And The Position Of The Lungs Heart And Larger Bloodvessels

In the human body there does not exist any such space as cavi...

Foreign Bodies In The Stomach

Gastroscopy is indicated in cases of a foreign body that ref...

Angina Pectoris

This is a name applied to pain in the region of the heart cau...

To Prevent Small-pox

Use _Macrotin_ 1st night and morning, and if nursing or expos...

Bleeding

In any case of this pack the feet and legs as directed in Lung...

Conclusive Remarks Obstacles

Before concluding my article, I shall attempt to remove a few...

Intermittent Fever Ague And Fever

Use the A D current. First, give general tonic treatment. (Se...

Tracheotomy

Indications.--Tracheotomy is indicated in dyspnea of laryngot...

Introduction Of The Esophagoscope

The esophagoscope is to be passed only with ocular guidance, ...

Technic Of Laryngeal Operations

Preparation of the patient and anesthesia have been mentione...

Our Spirit-levels

The Sixth Sense. Though we usually speak of having five sens...



Retrograde Esophagoscopy





Category: ACQUIRING SKILL
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

The first step is to get rid of the
gastric secretions. There is always fluid in the stomach, and this
keeps pouring out of the tube in a steady stream. Fold after fold is
emptied of fluid. Once the stomach is empty, the search begins for the
cardial opening. The best landmark is a mark with a dermal pencil on
the skin at a point corresponding to the level of the hiatus
esophageus. When it is desired to do a retrograde esophagoscopy and
the gastrostomy is done for this special purpose, it is wise to have
it very high. Once the cardia is located and the esophagus entered,
the remainder of the work is very easy. Bouginage can be carried out
from below the same as from above and may be of advantage in some
cases. Strictural lumina are much more apt to be concentric as
approached from below because there has been no distortion by pressure
dilatation due to stagnation of the food operating through a long
period of time. At retrograde esophagoscopy there seems to be no
abdominal esophagus and no cardia. The esophagoscope encounters only
the diaphragmatic pinchcock which seems to be at the top of the
stomach like the puckering string at the top of a bag.

Retrograde esophagoscopy is sometimes useful for stringing the
esophagus in cases in which the patient is unable to swallow a string
because he is too young or because of an epithelial scaling over of
the upper entrance of the stricture. In such cases the smallest size
of the author's filiform bougies (Fig. 40) is inserted through the
retrograde esophagoscope (Fig. 43) and insinuated upward through the
stricture. When the tip reaches the pharynx coughing, choking and
gagging are noticed. The filiform end is brought out the mouth
sufficiently far to attach a silk braided cord which is then pulled
down and out of the gastrostomic opening. The braided silk string
must be long enough so that the oral and the abdominal ends can be
tied together to make it endless; but before doing so the oral end
should be drawn through nose where it will be less annoying than in
the mouth. The purpose of the string is to pull up the retrograde
bougies (Fig. 35)





Next: Acquiring Skill

Previous: Complications Following Esophagoscopy



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 1261