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This frequent and severe trouble results most usually from chi...
The development of permanent injury to one or more valves o...
Bronchoscopic Oxygen Insufflation
Bronchoscopic oxygen insufflation is a life-saving measure eq...
Cold baths, while greatly to be recommended to those who are s...
This trouble appears in two opposite characters. In the one it...
Ulcers Case Xxviii
Mrs. U. aged 60, has been subject to ulcerated legs for sever...
See Consumption. ...
A Rampaging Infection
At the age of 40, John, an old bohemian client of mine, came ...
How To Get And Keep A Good Figure
Erect Position is the Result of Vigorous Health. Naturally an...
On The Adherent Eschar
It appears scarcely necessary to describe the immediate and w...
Often there follows, after the cure of an inflammatory disease...
Alkalis (eg Ammonia Soda Or Potash)
Give dilute vinegar, followed by white of egg. ...
Mineral Acids And Glacial Acetic
If any neutralising agent, such, e.g., as lime, chalk, soda, o...
Treatment Of Cicatricial Stenosis
A careful direct endoscopic examination is essential before ...
This is often an adjunct of old age, and sometimes occurs in t...
Varix And Angioma Of The Esophagus
These lesions are sometimes the cause of esophageal hemorrhag...
For this take two tablespoonfuls of hot water every five minut...
Esophageal Foreign Body
After initial choking and gagging, or without these, there m...
Esophagoscopy is demanded in every case in which a foreign b...
Growth Of Body
See Limb, Saving a. ...
Rupture And Trauma Of The Esophagus
Category: 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
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