Peroral endoscopy and laryngeal surgery . t in so doing the hook-like protector end of the i)in may causetrauma. It is better to hold the near end of the pin with the forcepswhile the esophagoscope is down over the pin. open safetypin lodged point upward in the esophagus presents certain peculiar ele-ments of danger, and peculiar difficulties of removal. When the esoph-agoscopist sees the [lin in the esophagoscope, the temjitation to seizeit and remove it is great. To do so is almost certain death. Besides therisk of septic mediastinitis and iileiiritis. there is the immediate surgical
Peroral endoscopy and laryngeal surgery . t in so doing the hook-like protector end of the i)in may causetrauma. It is better to hold the near end of the pin with the forcepswhile the esophagoscope is down over the pin. open safetypin lodged point upward in the esophagus presents certain peculiar ele-ments of danger, and peculiar difficulties of removal. When the esoph-agoscopist sees the [lin in the esophagoscope, the temjitation to seizeit and remove it is great. To do so is almost certain death. Besides therisk of septic mediastinitis and iileiiritis. there is the immediate surgical ESOPHAGOSCOPY FOR FOREIGN BODIES. risk. Two such cases have come to the writers knowledge by com-munications. In one instance, death was from hemorrhage into themediastinum. What vessel was perforated was not known. From thelocation of the pin, it was probably the aorta. In the other instance,shock from esophageal trauma was the cause. In adults or older chil-dren, the pin can be closed before removal as described in connection. Fig. 211.—Radiograph by Dr. George C. Johnston, showing open safety pin,point up, in the esophagus of an infant, aged eleven months. Pin was passed intostomach, turned and removed esophagoscopically. Pin retouched for clearness.(Authors case). with safety pins in the bronchi. The author has had a number of suchcases. In infants, the esophagus is already in such a state of tension bythe stretching spread of the spring (E, Fig. 212), that perforation is cer-tain if the dilatation of the insertion of an instrument be added. Thesolution of the mechanical problem of safe removal when the first under-noted case presented itself, led the author to devise a new method which ESOPHAGOSCOPV FOR FOREIGN BODIES. 351 is practicable for anyone who has practiced gastroscopy. Republicationhere of a report (Bib. 25(i) of the first two cases will suffice to illustratethe method. Elizabeth G., aged eleven months, referred by Dr. August Soffeland Dr. C. C. Sandels.
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