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See Erysipelas. ...
Period Of Incubation Or Hatching
The time which passes between the reception of the contagious...
Difficulties In The Introduction Of The Bronchoscope
The beginner may enter the esophagus instead of the trachea:...
Technic Of Specular Esophagoscopy
Recumbent patient. Boyce position. The larynx is to be expos...
Practice On The Dog
Having mastered the technic of introduction on the cadaver a...
Take B D current, moderate force. Treat exactly as in spermat...
Hair Coming Off
There are many forms of this disfiguring trouble, both in the ...
This is usually a result of stagnation of food or secretion, ...
Treatment Of The Violent Or Sthenic Form Of Scarlatina Anginosa
The _violent_, or _sthenic form_ of scarlatina anginosa becom...
How To Be Ill And Get Well
ILLNESS seems to be one of the hardest things to happ...
Cold In The Head
Infants often are prevented sucking by this form of cold closi...
Indications For Strychnin
Strychnin is a much overused drug. It is now given for almost...
See Child-bearing. ...
Anesthesia For Peroral Endoscopy
A dyspneic patient should never be given a general anesthetic...
The composition of different articles of food varies. A turnip ...
The diet of the sick should he nutricious, but at all times s...
Breast Swelling In
A blow on the breast, or the drain of nursing a child, along w...
Direct Laryngoscopy In Children
The epiglottis in children is usually strongly curled, often...
There is a usual (normal) temperature in all the blood and tis...
The Relative Position Of The Cranial Nasal Oral And Pharyngeal Cavities
On making a section (vertically through the median line) of t...
Tuberculosis Of The Esophagus
Category: DISEASES OF THE ESOPHAGUS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Esophageal tuberculosis is not commonly met, but is probably not
infrequently associated with the dysphagia of tuberculous laryngitis.
It may rarely occur as a primary infection, but usually the esophagus
is involved in an extension from a tuberculous process in the larynx,
mediastinal lymphatics, pleura, bronchi, or lungs.
Primary lesions appear as superficial erosions or ulcerations, with a
surrounding yellowish granular zone, or the granules may alone be
present. The mucosa in tuberculous lesions is usually pallid, the
absence of vascularity being marked. Invasion from the periesophageal
organs produces more or less localized compression and fixation of the
esophagus. The character of open ulceration is modified by the mixed
infections. Healed tuberculous lesions, sometimes resulting from the
evacuation of tuberculous mediastinal lymph nodes into the esophagus
may be encountered. The local fixation and cicatricial contraction may
be the site of a traction diverticulum. Tuberculous esophago-bronchial
fistulae are occasionally seen.
Diagnosis, to be certain, requires the demonstration of the
tubercule bacilli and the characteristic cell accumulation of the
tubercle in a specimen of tissue removed from the lesion.
Actinomycosis must be excluded, and the possibility of mixed luetic
and tuberculous lesions is to be kept in mind. Post-tuberculous
cicatrices have no recognizable characteristics.
Treatment.--The maintenance of nutrition to the highest degree, and
the institution of a strict antituberculous regime are demanded. Local
applications are of no avail. Gastrostomy for feeding should be done
if dysphagia be severe, and has the advantage of putting the esophagus
at rest. The passage of a stomach-tube for feeding purposes may be
done, but it is often painful, and is dangerous in the presence of
ulceration. Pain is not marked if the lesion be limited to the
esophagus, though if it is present orthoform, anesthesin, or
apothesin, in powder form, swallowed dry, may prove helpful.
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