The Hospital Bulletin, Vol. V, No. 3, May 15, 1909 — John Shaqi
The Hospital Bulletin, Vol. V, No. 3, May 15, 1909Various
History
The Hospital Bulletin, Vol. V, No. 3, May 15, 1909
Various
Medical colleges -- Alumni and alumnae -- Maryland -- Baltimore -- Periodicals; Medicine -- Periodicals
Three interesting cases have recently come under my observation, and
they illustrate so well the value of the esophagoscope I shall report
them somewhat in detail. The first patient was seen with Dr. E. B.
Freeman; she was 67 years old. The morning before she came to the
hospital, while eating ham, she swallowed a large piece that had not
been sufficiently masticated. It lodged in the introitus esophagi and
remained there. When she came to the hospital she had swallowed neither
solid nor liquid food for nearly thirty-six hours. A half hour before
examining the esophagus she was given a hypodermic of morphia and
atropia. With the patient in the sitting position the throat and upper
end of the esophagus were anesthetized with 10 per cent solution of
cocaine. Jackson's laryngeal speculum was introduced and the larynx
pulled forward. A large mass resembling somewhat an ulcerative
epithelioma was seen, and proved to be the piece of ham. Dr. Freeman and
I removed it piecemeal with Pfau's foreign body forceps. It required
about forty-five minutes to remove it entirely. The patient stood the
ordeal well, and was able to go home the same afternoon. For about a
week she had temperature, cough and expectoration, but ultimately made a
good recovery. In this case the esophagoscope probably saved the patient
an esophagotomy. The second patient was a female, thirty-three years
old, referred to me by Dr. J. F. Chisolm, of Savannah. While at an
oyster supper she attempted to swallow a large oyster, with the result
that she choked for a few seconds and then had a sense of fulness in the
region of the larynx. The next day she had some difficulty in
swallowing, so that she took only liquids. The second day afterward
swallowing was decidedly painful; she grew rapidly worse, until the
fourth day her condition was serious. She reached this city the morning
of the fifth day, with a temperature of 100 degrees and extreme
prostration. The examination of the esophagus was made under ether with
the head in the extended position. No foreign body was found, but the
upper end of the esophagus was red, swollen and edematous, and seemed to
be closed. The patient was given cold milk and ice bags to the throat.
For two days she suffered excruciating pain on swallowing, and it looked
as if we would have to resort to rectal feeding. The next day there was
slight amelioration of the pain, which gradually disappeared. In this
case the esophagoscope enabled us to see at once that a foreign body was
not present, and that the symptoms were due to a severe, acute
inflammation, probably caused by a piece of shell attached to the
oyster.
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