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Medical ArticlesNerve Shock
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At the outset, it must ever be remembered that this is not a d...
General Principles Of Position
As will be seen in Fig. 47 the trachea and esophagus are not...
Resume Of Tracheotomy
Instruments. Headlight Sandbag Scalpel Hemostats ...
Is the process whereby the digested food is carried into the b...
See Nostrils. ...
The need for this is often indicated by irritability of temper...
A Summing Up
GIVE up resentment, give up unhealthy resistance. ...
It is essential for the welfare of the patient, especially af...
Autodrownage is the name given by the author to the drowning...
Physical Signs Of Bronchial Foreign Body
In most cases there will be limitation of expansion on the in...
This peculiar burning and distressed feeling at the stomach d...
See Band, Flannel. ...
Inflammation Of The Lungs - Pneumonia
This disease is often connected with Pleurisy, and consists o...
Symptoms Of Tracheal And Bronchial Foreign Body
1. Tracheal foreign bodies are usually movable and their mo...
Early Symptoms Of Irritating Foreign Body Such As A Peanut Kernel In The Bronchus
1. Initial laryngeal spasm is almost invariably present wit...
Functional Hiatal Stenosis Hiatal Esophagismus Phrenospasm Diaphragmatic Pinchcock Stenosis
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Strangulation Or Hanging
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This affection, though it somewhat resembles a common boil, a...
Emetic; keep quiet and darken the room. Chloral or bromide of ...
Category: MALIGNANT DISEASE OF THE ESOPHAGUS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The present 100 per cent mortality in cancer of the
esophagus will be lowered and a certain percentage of surgical cures
will be obtained when patients with esophageal symptoms are given the
benefit of early esophagoscopic study. The relief or circumvention of
the dysphagia requires early measures to prevent food and water
starvation. Bouginage of a malignant esophagus to increase
temporarily the size of the stenosed lumen is of questionable
advisability, and is attended with the great risk of perforating the
weakened esophageal wall.
Esophageal intubation may serve for a time to delay gastrostomy but
it cannot supplant it, nor obviate the necessity for its ultimate
performance. The Charters-Symonds or Guisez esophageal intubation tube
is readily inserted after drawing the larynx forward with the
laryngoscope. The tube must be changed every week or two for cleaning,
and duplicate tubes must be ready for immediate reinsertion.
Eventually, a smaller, and then a still smaller tube are needed, until
finally none can be introduced; though in some cases the tube can be
kept in the soft mass of fungations until the patient has died of
hemorrhage, exhaustion, complications or intercurrent disease.
Gastrostomy is always indicated as the disease progresses, and it
should be done before nutrition is greatly impaired. Surgeons often
hesitate thus to operate on an inoperable case; but it must be
remembered that no one should be allowed to die of hunger and thirst.
The operation should be done before inanition has made serious
inroads. As in the case of tracheotomy, we always preach doing it
early, and always do it late. If postponed too long, water starvation
may proceed so far that the patient will not recover, because the
water-starved tissues will not take up water put in the stomach.