There are cases in which the outer skin has been taken off by ...
Scarlatina Sine Exanthemate
There are also mild cases of scarlet-fever, when little or no...
Emetic; castor oil and enema. ...
Use the A D current always in rheumatic affections. If there ...
TO argue with nervous anxiety, either in ourselves or...
During rheumatism the peripheral blood vessels are generally ...
Complications Following Esophagoscopy
These are to be avoided in large measure by the exercise of ...
This is a matter of great importance to the sick. Nor is anyth...
If the foreign body completely obstructs a main bronchus, pr...
Much more than is readily believed depends on the state of the...
Perversions In The Guidance Of The Body
SO evident are the various, the numberless perversion...
For use in our treatment we recommend Coutts' Acetic Acid. It ...
A MAN once grasped a very hot poker with his hand, an...
Technic For General Anesthesia
For esophagoscopy and gastroscopy, if general anesthesia is ...
Esophageal Foreign Body
After initial choking and gagging, or without these, there m...
Lumbago differs from both paralysis and cramp of the lower bac...
Many valuable lives have been saved by an elementary knowledge...
Bowels Glands Of
Symptoms of glandular trouble in the bowels are--weariness and...
I shall give a couple of illustrations: In the winter of 1...
Positive And Negative Manifestations
Acute diseases are to be regarded as electrically positive, a...
Category: ESOPHAGOSCOPY FOR FOREIGN BODY
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Safety-pins in children, point upward,
when lodged high in the cervical esophagus may be readily removed with
the aid of the laryngoscope, or esophageal speculum. The keeper end is
grasped with the alligator forceps, while the spatular tip of the
laryngoscope is worked under the point. Instruments and foreign body
are then removed together. Often the pin point will catch in the
light-chamber where it is very safely lodged. If the pin be then
pulled upon it will straighten out and may be withdrawn through the
[FIG. 94.--Endogastric version. One of the author's methods of removal
of upward pointed esophageally lodged open safety-pins by passing them
into stomach, where they are turned and removed. The first
illustration (A) shows the rotation forceps before seizing pin by the
ring of the spring end. (Forceps jaws are shown opening in the wrong
diameter.) At B is shown the pin seized in the ring by the points of
the forceps. At C is shown the pin carried into the stomach and about
to be rotated by withdrawal. D, the withdrawal of the pin into the
esophagoscope which will thereby close it. If withdrawn by flat-jawed
forceps as at F, the esophageal wall would be fatally lacerated.]
Double pointed tacks and staples, when lodged point upward, must be
turned so that the points trail on removal. This may be done by
carrying them into the stomach and turning them, as described under
The extraction of foreign bodies of very large size from the
esophagus is greatly facilitated by the use of general anesthesia,
which relaxes the spasmodic contractions of the esophagus often
occurring when attempt is made to withdraw the foreign body. General
anesthesia, though entirely unnecessary for introduction of the
esophagoscope, in any case may be used if the body is large, sharp,
and rough, in order to prevent laceration through the muscular
contractions otherwise incident to withdrawal.* In exceptional cases
it may be necessary to comminute a large foreign body such as a tooth
plate. A large smooth foreign body may be difficult to seize with
forceps. In this case the mechanical spoon or the author's safety-pin
closer may be used.
* It must always be remembered that large foreign bodies are very
prone to cause dyspnea that renders general anesthesia exceedingly
dangerous especially in children.
[FIG. 95.--Lateral roentgenogram of a safety-pin in a child aged 11
months, demonstrating the esophageal location of the pin in this case
and the great value of the lateral roentgenogram in the localization
of foreign bodies. The pin was removed by the author's method of
endogastric version. (Plate made by George C. Johnston )]
The extraction of meat and other foods from the esophagus at the
level of the upper thoracic aperture is usually readily accomplished
with the esophageal speculum and forceps. In certain cases the
mechanical spoon will be found useful. Should the bolus of food be
lodged at the lower level the esophagoscope will be required.
Next: Extraction Of Foreign Bodies From The Strictured Esophagus
Previous: Endogastric Version