Diffuse Dilatation Of The Esophagus

This is practically always due to stagnation ectasia, which is

invariably associated with either organic or spasmodic stricture,

existing at the time of observation or at some time prior thereto. The

dilating effect of the repeatedly accumulated food results in a

permanent enlargement, so that the esophagus acts as the reservoir of

a large funnel with a very small opening. When food is swallowed the

esophagus fills, and the contents trickle slowly through the opening.

Gases due to fermentation increase the distension and cause substernal

pressure, discomfort, and belching. A very large dilatation of the

thoracic esophagus indicates spastic stenosis. Cicatricial stenoses do

not result in such large dilatations and the dilatation above a

malignant stenosis is usually slight, probably because of its

relatively shorter duration.

The treatment of diffuse esophageal dilatation consists in dilating

the diaphragmatic pinchcock that is, the hiatal esophagus. Chronic

esophagitis is to be controlled by esophageal lavage, the regulation

of the diet to liquefiable foods and the administration of bismuth

subnitrate. The patient can be taught to do the lavage. The local

esophagoscopic application of a small quantity of a 25 per cent watery

solution of argyrol may be required for the static esophagitis. The

redundancy probably never disappears; but functional and subjective

cures are usually obtainable.

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