Medical ArticlesEsophagoscopy For Foreign Body
Inflammation Of The Brain
_Brain Fever._ Though this affection is not strictly what ...
_Nux Vomica_ should be used once in about four hours, for twe...
The various articles under Nerves and Nervousness should be re...
I KNOW a woman who says that if she wants to get her ...
Choice Of Time To Do Bronchoscopy For Foreign Body
The difficulties of removal usually increase from the time of...
Is the process whereby the digested food is carried into the b...
As the patient should have a constant supply of pure air for ...
Bruises Case Xiv
The first case of bruise which I shall detail was not severe,...
Positive And Negative Manifestations
Acute diseases are to be regarded as electrically positive, a...
Symptomatology And Treatment Of Chronic Valvular Lesions
Before discussing the treatment of broken compensation in gen...
Menorrhagia Excessive Menstruation
If the menstrual flow is apt to terminate in hemorrhage, it i...
Of Punctures Etc
In cases of recent punctured wounds the orifice and surroundi...
Treatment Of Affections Of The Nervous Centres
In affections of the nervous centres, the _brain_, the _cereb...
Blood Supply Of
To supply good blood in cases where it is lacking, either from...
Condition Of The Throat And Other Internal Organs
The condition of the _throat_ requires the most constant atte...
Mitral Stenosis: Mitral Narrowing
This particular valvular defect occurs more frequently in wom...
The Malignant Forms Of Scarlet-fever
are caused by the character of the epidemy, but, perhaps, mor...
Site Of Lodgement
Almost all foreign bodies are arrested in the cervical esoph...
In this trouble there is indicated a failure somewhere of the ...
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.