Medical ArticlesStage I Entering The Right Pyriform Sinus
The operator standing (as in Fig. 66), inserts the esophagos...
Violent Reaction Sthenic
If both, the contagious poison and the organism, are very str...
Chronic Stenosis Of The Larynx And Trachea
The various forms of laryngeal stenosis for which tracheotomy...
Thorough heating, with moist heat is the best treatment for th...
These are often piled on the front of the body, while the far ...
How Fasting Heals
Its an old hygienic maxim that the doctor does not heal, the ...
It is sometimes desired to make traction on an irregularly s...
The Sixth Sense. Though we usually speak of having five sens...
The first sign of such an illness is a brief and slight attack...
Is applicable to inflamed eyes, in the early stage, where the...
Constipation Of Bowels
This disease may proceed from either a negative condition--a ...
Take A D current, very mild force. Introduce the vaginal elec...
To Prevent Typhoid Fever
When exposed, as in nursing the sick, take _Baptisia_ 2d, and...
A whispering voice can always be had as long as air can pass...
If the patient is weak, the circulation depressed, the blood ...
Burns Case Xxxv
The following case will present a specimen of my trials of th...
When soft, friable substances, such as a bolus of meat, beco...
With the forceps illustrated in Fig. 28 specimens of tissue ...
Treatment Of Broken Compensation
The consideration of this subject will include the following ...
Auricular Fibrillation Treatment
The condition may be stopped by relieving the heart and circu...
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pulled upon it will straighten out and may be withdrawn through the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