Treatment





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

following solution:

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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