VIEW THE MOBILE VERSION of www.homemedicine.ca Informational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Clinical Interpretation Of Pulse Tracings

A moment may be spent on clinical interpretation of pulse tra...

A Summing Up

GIVE up resentment, give up unhealthy resistance. ...

Tumours

A large, soft, fleshy tumour is usually simply an accumulation...

General Tonic Treatment

Take the B D current, (A D is very good), of fair medium stre...

Potato Poultice

Potatoes boiled and beaten up with buttermilk, spread out in t...

Catarrh Chronic

If in the head, first give face-bath, as in common colds, exc...

Of Burns

The application of the lunar caustic in recent burns or scald...

Treatment

In this rapid high tension age the physician should be as ene...

In Excessive Heat And Continuous Delirium A Half-bath May Be Given

also, every time the packing sheet is changed. The rule is that...

Symptomatology And Diagnosis Of Foreign Bodies In The Air And Food Passages

Initial symptoms are choking, gagging, coughing, and wheezing...

Armpit Swelling

Often this comes as the result of a chill, or of enfeeblement ...

Other Sequels Dropsy &c

Beside the ulceration of glands and deafness, some of the seq...

Thuya

is a specific when locally used for _Sycosis_, also for fungo...

Cuprum Aceticum

(_Acetate of Copper Verdigris_) applied to _Cancerous_ ulcers...

Paracelsus

THEOPHRASTUS BOMBASTUS VON HOHENHEIM, commonly known as Parac...

The Throat Should Be Covered With A Wet Compress I E A Piece Of

linen four to eightfold, according to its original thickness, d...

Physical Signs Of Tracheal Foreign Body

If fixed in the trachea the only objective sign of foreign bo...

Bronchial Stenosis

Stenosis of one or more bronchi results at times from cicatr...

Rules For Insertion Of The Catheter For Insufflation Anesthesia

1. The patient should be fully under the anesthetic by the ...

Bruises

For slight bruises, such as children frequently get by falling...



The Roentgenographic Signs Of Expiratory-valve-like Bronchial Obstruction





Category: FOREIGN BODIES IN THE AIR AND FOOD PASSAGES
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

The roentgenray signs in expiratory valve-like obstruction of a
bronchus are those of an acute obstructive emphysema (Fig. 74),
namely,
1. Greater transparency on the obstructed side (Iglauer).
2. Displacement of the heart to the free side (Iglauer).
3. Depression and flattening of the dome of the diaphragm on the
invaded side (Iglauer).
4. Limitation of the diaphragmatic excursion on the obstructed side
(Manges).

It is very important to note that, as discovered by Manges, the
differential emphysema occurs at the end of expiration and the plate
must be exposed at that time, before inspiration starts. He also noted
that at fluoroscopy the heart moved laterally toward the uninvaded
side during expiration.*

* Dr. Manges has developed such a high degree of skill in the
fluoroscopic diagnosis of non-opaque foreign bodies by the obstructive
emphysema they produce that he has located peanut kernels and other
vegetable substances with absolute accuracy and unfailing certainty in
dozens of cases at the Bronchoscopic Clinic.

[FIG. 74--Expiratory valve-like bronchial obstruction by
non-radiopaque foreign body, producing an acute obstructive emphysema.
Peanut kernel in right main bronchus. Note (a) depression of right
diaphragm; (b) displacement of heart and mediastinum to left; (c)
greater transparency of the invaded side. Ray-plate made by Willis F.
Manges.]

Complete bronchial obstruction shows a density over the whole area
the aeration and drainage of which has been cut off (Fig. 75).
Pulmonary abscess formation and drowned lung (accumulated secretion
in the bronchi and bronchioli) are shown by the definite shadows
produced (Fig. 76).

[140] Dense and metallic objects will usually be readily seen in the
roentgenograms and fluoroscope, but many foreign bodies are of a
nature which will produce no shadow; the roentgenologist should,
therefore, be prepared to interpret the pulmonary pathology, and
should not dismiss the case as negative for foreign body because one
is not seen. Even metallic objects are in rare cases exceedingly
difficult to demonstrate.

[FIG. 75.--Radiograph showing pathology resulting from complete
obstruction of a bronchus with atelectasis and drowned lung resulting.
Foot of an alarm clock in left bronchus of 4 year old child. Present
25 days. Plate made by Johnston and Grier.]

Positive Films of the Tracheo-bronchial Tree as an Aid to
Localization.--In order to localize the bronchus invaded by a small
foreign body the positive film is laid over the negative of the
patient showing the foreign body. The shadow of the foreign body will
then show through the overlying positive film. These positive films
are made in twelve sizes, and the size selected should be that
corresponding to the size of the patient as shown by the
roentgenograph. The dome of the diaphragm and the dome of the pleura
are taken as visceral landmarks for placing the positive films which
have lines indicating these levels. If the shadow of the foreign body
be faint it may be strengthened by an ink mark on the
uncoated side of the plate.

[FIG. 76.--Partial bronchial obstruction for long period of time
Pathology, bronchiectasis and pulmonary abscess, produced by the
presence for 4 years of a nail in the left lung of a boy of 10 years]

Bronchial mapping is readily accomplished by the author's method of
endobronchial insufflation of a roentgenopaque inert powder such as
bismuth subnitrate or subcarbonate (Fig. 77). The roentgenopaque
substance may be injected in a fluid mixture if preferred, but the
walls are better outlined with the powder (Fig. 77).

[FIG. 77.--Roentgenogram showing the author's method of bronchial
mapping or lung-mapping by the bronchoscopic introduction of opaque
substances (in this instance powdered bismuth subnitrate) into the
lung of the patient. Plate made by David R. Bowen. (Illustration,
strengthened for reproduction, is from author's article in American
Journal of Roentgenology, Oct., 1918.)]





Next: Errors To Avoid In Suspected Foreign Body Cases

Previous: Roentgenray Study In Foreign Body Cases



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 970