Pediatrics : the hygienic and medical treatment of children . en-larged thymus. At times, in infants, a broadening of the shadowto the right may be due to the great vessels, but notable broad-ening to the left is only due to the thymus. The shadow of en-larged bronchial lymphnodes may sometimes suggest a thymic en-largement. Usually, however, enlarged bronchial lymphnodes givean extra median shadow to one side, which does not connect withthe heart shadow. Special Methods of Examination.—Various special methods ofpercussing the thymus, and even special instruments have beendevised. These, howev
Pediatrics : the hygienic and medical treatment of children . en-larged thymus. At times, in infants, a broadening of the shadowto the right may be due to the great vessels, but notable broad-ening to the left is only due to the thymus. The shadow of en-larged bronchial lymphnodes may sometimes suggest a thymic en-largement. Usually, however, enlarged bronchial lymphnodes givean extra median shadow to one side, which does not connect withthe heart shadow. Special Methods of Examination.—Various special methods ofpercussing the thymus, and even special instruments have beendevised. These, however, are not adapted to use in ordinary prac-tice. Skilled observers have been able to demonstrate the existenceof tracheal stenosis by means of the bronchoscope. This also is notof much practical value. In some cases of thymic enlargement anotable lymphocytosis has been found on blood examination. Thiswould be of more value in older children than in infants, but cannotbe taken as more than a confirmatory sign. 362 Diseases of the Ductless Glands Fig. 249. X-ray of enlarged thymus Differential Diagnosis.—Enlarged , thymus must be differen-tiated chiefly from the other causes of dyspnea and obstructed breath-ing. The other causes of stridulous dyspnea are enlargement of thebronchial lymphnodes, retropharyngeal abscess, membranous laryn-gitis, catarrhal spasm of the larynx, laryngospasm, congenital laryn-geal stridor, and asthma. Enlarged th^rous must also be differen-tiated from the diseases of the heart and lungs which are associatedwith dyspnea. PROGNOSIS.—The outlook in any case in which a diagnosis ofenlargement of the thymus has been made is very uncertain. Whileany attack, no matter how severe the symptoms, may be recovered Enlarged Thymus 363 from, it must always be remembered that these cases are likely tohave a low resistance to injurious influences, and are liable to suddendeath from comparatively slight cause. TREATMENT.— Cases of thymic enlargement showing any
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatr, bookyear1917
