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Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Acute esophagitis calls for rest in bed, sterile liquid
food, and the administration of bismuth powder mentioned in the
paragraph on contraindications. An ice bag applied to the neck may
afford some relief. The mouth should be hourly cleansed with the
Dakin's solution 1 part
Cinnamon water 5 parts.
Emphysema unaccompanied by pyogenic processes usually requires no
treatment, though an occasional case may require punctures of the skin
to liberate the air. Gaseous emphysema and pus formation urgently
demand early external drainage, preferably behind the sternomastoid.
Should the pleura be perforated by sudden puncture pyo-pneumothorax is
inevitable. Prompt thoracotomy for drainage may save the patient's
life if the mediastinum has not also been infected. Foreign bodies
ulcerating through may reach the lung without pleural leakage because
of the sealing together of the visceral and parietal pleurae. In the
serious degrees of esophageal trauma, particularly if the pleura be
perforated, gastrostomy is indicated to afford rest of the esophagus,
and for alimentation. A duodenal feeding tube may be placed through an
esophagoscope passed into the stomach in the usual way through the
mouth, avoiding by ocular guidance the perforation into which a
blindly passed stomach tube would be very likely to enter, with
probably dangerous results.
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