Medical ArticlesTricuspid Insufficiency
This rarely, if ever, occurs alone; it is generally a sequenc...
Cures Losing Their Effect
After a fortnight's treatment often matters seem to come to a ...
Diseases And Disturbances Of The Skin
Their Chief Causes. Skin troubles are of two main kinds accor...
Like any other muscular tissue, the heart hypertrophies whe...
Emetic; stimulate and keep warm; keep patient lying down. ...
To Prevent Dysentery
In hot weather when bilious diseases prevail, use _Mercurius_...
An ulcer is an "eating sore": that is, a sore containing matte...
The Surgical Dissection Of The Principal Bloodvessels And Nerves Of The Iliac And Femoral Regions
Through the groin, as through the axilla, the principal blood...
See Fever, Rheumatic. ...
Cardiovascular Renal Disease Treatment
While it is urged, in preventing the actual development of th...
These are of two kinds, the one purely imaginary, the other wh...
Ulcers Case Xxiii
Mr. Marshall, aged 60, had a troublesome ulcer under the oute...
Difficulties Of Direct Laryngoscopy
The larynx can be directly exposed in any patient whose mout...
The Blood Vessels
Where the Body Does its Real Eating. When once the food has b...
The Use Of The Brain
LET us now consider instances where the brain alone i...
This disease consists in a looseness of the bowels, generally...
This disease, in addition to the symptoms of cutting, crampin...
Get a sufficient quantity of good bran in an ordinary washhand...
IN climbing a mountain, if we know the path and take it as a ...
Why Fuss So Much About What I Eat?
I KNOW a woman who insisted that it was impossible fo...
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pulled upon it will straighten out and may be withdrawn through the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