After the bath, the patient is rubbed dry, and either taken t...
_Tis a gift to be simple Tis a gift to be free, Tis a gift ...
Conditions Causing Change In Blood Pressure
Woolley [Footnote: Woolley, P. G.: Factors Governing Vascular...
Lessons From Nutritional Anthropology
The next logical pair of questions are: how healthy could goo...
Anesthesia In Heart Disease
While no physician likes to give an anesthetic to a patient w...
Additional Rules For The Treatment Of Eruptive Diseases
In all these eruptive diseases, especially small-pox, all I h...
Benign Growths Primary In The Tracheobronchial Tree
Extension of papillomata from the larynx into the cervical tr...
Other Forms Of Rest
DO you hold yourself on the chair, or does the chair ...
Vitamin Program For The Sick
No matter which way you look at it or how well insured you ma...
Indications For Esophagoscopy In Disease
Any persistent abnormal sensation or disturbance of function...
A mother who has had strength to bear a child is, as a rule, q...
Suck the wound, and apply a drop or two of strong ammonia to t...
Lues Of The Tracheobronchial Tree
Compared to laryngeal involvement, syphilis of the tracheobr...
Often very serious trouble takes the form of simple overwhelmi...
WHEN we face the matter squarely and give it careful ...
(_Acetate of Copper Verdigris_) applied to _Cancerous_ ulcers...
A Rampaging Infection
At the age of 40, John, an old bohemian client of mine, came ...
Length Of Bath
Although the temperature, in sthenic cases, should be a littl...
A large, soft, fleshy tumour is usually simply an accumulation...
Position For Bronchoscopy And Esophagoscopy
The dorsally recumbent patient is so placed that the head an...
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.