|VIEW THE MOBILE VERSION of www.homemedicine.ca|| Informational|
_Nux Vomica_ should be used once in about four hours, for twe...
Children are not unfrequently born with this deformity in one ...
The Fundamental Principle
If you are a true believer in any of the above food religions...
Remedy Finding A
It will sometimes occur, in the case of those endeavouring to ...
Testing For Electric Defects
These tests should be made beforehand; not when about to com...
The following are the antidotes and remedies for some of the m...
Cold In The Head
Infants often are prevented sucking by this form of cold closi...
The disease known by this name in Canada breaks out in the han...
Few vital processes are more remarkable than that by which foo...
_Erysipelas_ being commonly the reflexion of an internal dise...
It is not always easy to say definitely whether a bone is brok...
This arises from the undue contraction of some of the muscles ...
From The Hygienic Dictionary
Diagnosis.  In the United States, making a diagnosis impli...
Next to those most dangerous forms--most dangerous, because t...
The cooking of vegetables requires particular care. The valuab...
This disease, in addition to the symptoms of cutting, crampin...
What is commonly called a "cough and spit" is sometimes due to...
To understand the physiology, pathology and the best treatmen...
See Veins, Swollen, etc. ...
THERE are very few persons who have not I had the experience ...
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