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THE ability to be easily and heartily amused brings a wholeso...
See Baths for Head. ...
If the disease be general in the system, moving from place to...
Ice-water And Snow-bath In Malignant Cases
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This is the accumulation of gases in the body, usually caused ...
Cancer In Face
Treat as far as possible as recommended for breast cancer. ...
The Development Of My Own Constipation
The history of my own constipation, though it especially rela...
Torpid Reaction Asthenic
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Delirium In Fever
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What Kind Of Food Should We Eat?
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Bronchoscopic And Esophagoscopic Grasping Forceps
are of the tubular type, that is, a stylet carrying the jaws...
This is a name applied to pain in the region of the heart cau...
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.