Informational Site NetworkInformational Site Network
Privacy
 


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Inflammation Of The Bowels - Enteritis

This consists in inflammation of the muscular and peritoneal ...

Oxygen Tank And Tracheotomy Instruments

Respiratory arrest may occur from shifting of a foreign body,...

Exercise

Where this is advised medically, it is often taken in a manner...

Healing

For healing wounds, burns, ulcers, irritation of mucous membr...

Perspiration

By this term we mean not only the sensible perspiration which ...

Continuation Of Packs Convalescence

Whether the eruption appear or not, the packs should be conti...

Diagnosis

It has been estimated that 70 per cent of stenoses of the es...

Head Baths

See Baths for Head. ...

Emergencies

5. Cardiac Emergency Drugs.--Besides some of the drugs alread...

Working Restfully

ONCE met a man who had to do an important piece of sc...

Etiology

Rheumatism is the cause of most instances of cardiac disease ...

Why People Get Sick

This is the Theory of Toxemia. A healthy body struggles conti...

Tracheobronchial Diphtheria

Urgent dyspnea in diphtheria when no membrane and but slight...

Adherent Pericarditis

Following dry pericarditis or pericarditis with an exudate, ...

Indications

Esophagoscopy is demanded in every case in which a foreign b...

Diet For A Long, Long Life

Some people not only want to be healthy, but they want to liv...

Dropsy

Use the A D current, moderate force. Give general tonic treat...

Tetanus

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

Caffein

Caffein can irritate the heart and cause irregularity and ta...

Action Of The Sitz-bath Explained

The _sitz-bath_ acts in a direct manner upon the abdominal or...



Spasmodic Stenosis Of The Esophagus





Category: DISEASES OF THE ESOPHAGUS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

Etiology - The functional activity of the esophagus is dependent upon
reflex action. The food is propulsed in a peristaltic wave by the same
mechanism as, and through an innervation (Auerbach and Meissner
plexus) similar to that which controls intestinal movements. The vagus
also is directly concerned with the deglutitory act, for swallowing is
impossible if both vagi are cut. Anything which unduly disturbs this
reflex arc may serve as an exciting cause of spasmodic stenosis.
Bolting of food, superficial erosions, local esophageal disease, or a
small foreign body, may produce spasmodic stenosis. Spasm secondary to
disease of the stomach, liver, gall bladder, appendix, or other
abdominal organ is clinically well recognized. A perpetuating cause in
established cases is undoubtedly nerve cell habit, and in many cases
there is an underlying neurotic factor. Shock as an exciting cause has
been well exemplified by the number of cases of phrenospasm developing
in soldiers during the World War.

Cricopharyngeal spasmodic stenosis usually presents the subjective
symptom of difficulty in starting the bolus of food downward. Once
started, the food passes into the stomach unimpeded. Regurgitation, if
it occurs, is immediate. The condition consists in a tonic
contraction, ahead of the bolus, of the circular fibers of the
inferior constrictor known as the cricopharyngeus muscle, or in a
failure of this muscle to relax so as to allow the bolus to pass. In
either case the disorder may be secondary to an organic lesion. Local
malignant disease or foreign bodies may be the cause. Globus
hystericus, lump in the throat, and the sense of constriction and
choking during emotion are due to the same spasmodic condition.

Diagnosis - At esophagoscopy there will be found marked exaggeration
of the usual spasm which occurs at the cricopharyngeus during the
introduction of the tube. The lumen may assume various shapes, or be
so tightly closed that the folds form a mammilliform projection in the
center. If the spasm gradually yields, and a full-sized esophagoscope
passes without further resistance, it may be stated that the esophagus
is of normal calibre, and a diagnosis of spasmodic stenosis can be
made. Considerable experience is required to distinguish between
normal and pathologic spasm in an unanesthetized individual. To the
less experienced esophagoscopist, examination under ether anesthesia
is recommended. Deep anesthesia will relax the normal cricopharyngeal
reflex closure as well as any abnormal spasm, thus assisting in the
differentiation between an organic stricture and one of functional
character. Under deep general anesthesia, however, it is impossible to
differentiate between the normal reflex and a spasmodic condition,
since both are abolished. Many cases of intermittent esophageal
stenosis supposed to be spasmodic are due to organic narrowness of
lumen plus lodgement of food, obstructive in itself and in the
esophagitis resulting from its presence. The organic narrowing,
congenital or pathologic, is readily recognizable esophagoscopically.

Treatment.--The fundamental cause of the disturbance of the reflex
should be searched for, and treated according to its nature. Purely
functional cases are often cured by the passage of a large
esophagoscope. Recurrences may require similar treatment.





Next: Functional Hiatal Stenosis Hiatal Esophagismus Phrenospasm Diaphragmatic Pinchcock Stenosis

Previous: Diffuse Dilatation Of The Esophagus



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 2543