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Anomalies Of The Esophagus

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Palpitation Of The Heart

This is commonly a symptomatic or sympathetic affection--rare...

Children's Swellings

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Catarrh Acute

If in the head, treat as prescribed for common colds in the h...


The symptoms of this are cramping pains in the abdomen, witho...

Cardiovascular Renal Disease

With the strennousness of this era, this disease or conditi...

Methods Of Treatment

Irritating applications probably provoke recurrences, becaus...


Often in cases where our treatment fails to cure, the failure ...

Animal Fats

The Digestibility of Fats. We have now come to the last group...

Taking A Laryngeal Specimen For Diagnosis

The diagnosis of carcinoma, sarcoma, and some other conditio...


This is the accumulation of gases in the body, usually caused ...

Physical Signs In Esophageal Foreign Body

There are no constant physical signs associated with uncompli...


How Nuts should be Used. Another form of fat is the meat of ...

Pulmonary Phthisis Consumption

After tubercles have been formed extensively in the lungs, an...

Baths For Head

In many cases of indigestion and brain exhaustion head-baths a...

Night Pains

If these are of the nature of cramps, which come on while lyin...

Home Methods Of Purifying Water

Boiling. Where the water that you are obliged to drink is not...

Length Of The Fast

How long should a person fast? In cases where there are serio...

From The Hygienic Dictionary

Diagnosis. [1] In the United States, making a diagnosis impli...

Throat Hoarseness

This is best treated by a good large BRAN POULTICE (see) on th...

Stage 4 Passing Through The Hiatus Esophageus

Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

When the head is
dropped, it must at the same time be moved horizontally to the right
in order that the axis of the tube shall correspond to the axis of the
lower third of the esophagus, which deviates to the left and turns
anteriorly. The head and shoulders at this time will be found to be
considerably below the plane of the table top (Fig. 71). The hiatal
constriction may assume the form of a slit or rosette. If the rosette
or slit cannot be promptly found, as may be the case in various
degrees of diffuse dilatation, the tube mouth must be shifted farther
to the left and anteriorly. When the tube mouth is centered over the
hiatal constriction moderately firm pressure continued for a short
time will cause it to yield. Then the tube, maintaining this same
direction will, without further trouble glide into and through the
abdominal esophagus. The cardia will not be noticed as a constriction,
but its appearance will be announced by the rolling in of reddish
gastric mucosal folds, and by a gush of fluid from the stomach.

[FIG. 70.--Schematic illustration of the author's high-low method of
esophagoscopy, fourth stage. Passing the hiatus. The head is dropped
from the position of the 1st and 2nd stages, CL, to the position T,
and at the same time the head and shoulders are moved to the right
(without rotation) which gives the necessary direction for passing the

[FIG. 71.--Esophagoscopy by the author's high-low method. Stage 4.
Passing the hiatus The patient's vertex is about 5 cm. below the top
of the table.]

Normal esophageal mucosa under proper illumination is glistening and
of a yellowish or bluish pink. The folds are soft and velvety,
rendering infiltration quickly noticeable. The cricoid cartilage shows
white through the mucosa. The gastric mucosa is a darker pink than
that of the esophagus and when actively secreting, its color in some
cases tends toward crimson.

Secretions in the esophagus are readily aspirated through the
drainage canal by a negative pressure pump. Food particles are best
removed by sponge pumping, or with forceps. Should the drainage
canal become obstructed positive pressure from the pump will clear the

Next: Difficulties Of Esophagoscopy

Previous: Stage 3 Passing Through The Thoracic Esophagus

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