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Medical ArticlesAcute Mild EndocarditisThis inflammation of the endocardium is generally confined to... Purple Spots On Skin These arise first as small swellings. The swellings fall, and ... Starches Sources of Starch. The starches are valuable and wholesome fo... The Triviality Of Trivialities LIFE is clearer, happier, and easier for us as things assume ... Polar Antagonism When the conducting cords are of equal length, as commonly th... Preparation Of Medicine As it often becomes necessary for the practitioner to make mo... To Prevent Small-pox Use _Macrotin_ 1st night and morning, and if nursing or expos... Talismans A talisman may be described as an emblematical object or im... Biliary Calculi Gravel In Liver Take A C current, strong as can be borne; and treat the infla... Cases During an epidemic of scarlatina in 1836 two of my children w... Plain Every-day Common Sense PLAIN common sense! When we come to sift everything d... Putrid Symptoms Next to those most dangerous forms--most dangerous, because t... Ulcers Case Xxii J. Copeland, blacksmith, aged 38, came to me with many deep ... Strychnine Emetic; keep quiet and darken the room. Chloral or bromide of ... Difficulties Of Esophagoscopy The beginner may find the esophagoscope seemingly rigidly fi... Ulceration Of The Esophagus Superficial erosions of the esophagus are by no means an unco... Common Colds Take the B D Faradaic current--moderate strength. If the affe... The Surgical Dissection Of The Superficial Bloodvessels Etc Of The Inguino-femoral Region Hernial protrusions are very liable to occur at the inguino-f... Diet As intimated in the preceding paragraph, the diet during end... Rheumatic Fever See Fever, Rheumatic. ... |
Rupture And Trauma Of The EsophagusCategory: DISEASES OF THE ESOPHAGUS Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery These may be spontaneous or may ensue from the passage of an instrument, or foreign body, or of both combined, as exemplified in the blind attempts to remove a foreign body or to push it downwards. Digestion of the esophagus and perforation may result from the stagnation of regurgitated gastric juice therein. This condition sometimes occurs in profound toxic and debilitated states. Rupture of the thoracic esophagus produces profound shock, fever, mediastinal emphysema, and rapid sinking. Pneumothorax and empyema follow perforation into the pleural cavity. Rupture of the cervical esophagus is usually followed by cervical emphysema and cervical abscess, both of which often burrow into the mediastinum along the fascial layers of the neck. Lesser degrees of trauma produce esophagitis usually accompanied by fever and painful and difficult swallowing. The treatment of traumatic esophagitis consists in rest in bed, sterile liquid food, and the administration of bismuth subnitrate (about one gramme in an adult), dry on the tongue every 4 hours. Rupture of the esophagus requires immediate gastrostomy to put the esophagus at rest and supply necessary alimentation. Thoracotomy for drainage is required when the pleural cavity has been involved, not only for pleural secretions, but for the constant and copious esophageal leakage. It is not ordinarily realized how much normal salivary drainage passes down the esophagus. The customary treatment of shock is to be applied. No attempt should be made to remove a foreign body until the traumatic lesions have healed. This may require a number of weeks. Decision as to when to remove the intruder is determined by esophagoscopic inspection. Subcutaneous emphysema does not require puncture unless gaseous, or unless pus forms. In the latter event free external drainage becomes imperative. Next: Acute Esophagitis Previous: Anomalies Of The Esophagus
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