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

Dysmenorrhea Painful Menstruation

If the disease be occasioned by uterine displacement, obstruc...

Onion Cases

All too many of my cases are what I privately refer to as oni...

Laryngoscopes

The regular type of laryngoscope shown in Fig. I (A, B, C) i...

Diet For The Chronically Ill

The chronically ill person has a long-term degenerative con...

Errors To Avoid In Suspected Foreign Body Cases

1. Do not reach for the foreign body with the fingers, lest...

Cases

During an epidemic of scarlatina in 1836 two of my children w...

Lues Of The Tracheobronchial Tree

Compared to laryngeal involvement, syphilis of the tracheobr...

Shivering

This is often a trivial matter, but sometimes it is a symptom ...

Rules For Direct Laryngoscopy

1. The laryngoscope must always be held in the left hand, nev...

Vitamins For An Older Healthy Person

Someone who is beyond 35 to 40 years of age should still feel...

Irritable Husbands

SUPPOSE your husband got impatient and annoyed with y...

Hot Flushings

See Flushings. ...

Common Cramp

Although either the positive or the negative pole, applied to...

Instructions To The Patient

Before beginning endoscopy the patient should be told that h...

Worry

One of the most fruitful causes of ill-health is the habit of ...

Erysipelas

This is a disease of the skin, producing redness, burning and...

Vegetables Green And Fruit

We would strongly recommend our readers to continually have th...

Cadaver Practice

The fundamental principles of peroral endoscopy are best tau...

During And After Desquamation The Treatment Should Be Continued As

indicated in milder cases, except the throat continue troubleso...

The Contagion Of Scarlatina Very Active

The _contagion_ of scarlatina is very active, and adheres for...



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 1132