Modern surgery, general and operative . Fig. 595.—^Authors case of whistle in esophagus, removed by external esophagotoniy. The symptoms are \ariable; if the body is large, there will be pain anddifficulty in swallo-^dng, and, in many cases, dyspnea from pressure uponthe trachea or bronchus. Occasionally the dyspnea is such a prominentfeature that it misleads the physician into the belief that the foreign bodyis lodged in the air-passages. Death may actually result from asphyxia. Insome other cases the symptoms are very slight. If the body is sharp, therewill be hemorrhage and severe pain. The
Modern surgery, general and operative . Fig. 595.—^Authors case of whistle in esophagus, removed by external esophagotoniy. The symptoms are \ariable; if the body is large, there will be pain anddifficulty in swallo-^dng, and, in many cases, dyspnea from pressure uponthe trachea or bronchus. Occasionally the dyspnea is such a prominentfeature that it misleads the physician into the belief that the foreign bodyis lodged in the air-passages. Death may actually result from asphyxia. Insome other cases the symptoms are very slight. If the body is sharp, therewill be hemorrhage and severe pain. The blood may be haw^ked up, or may. Fig. 596.—Authors case of jackstone in esophagus, removed by external esophagotomy. be swallowed and vomited. In rare cases a patient grows accustomed to aforeign body and ceases to notice it; but, more often, the foreign body pro-duces inflammation. It may even ulcerate into the wind-pipe, the pleura,the pericardium, or the aorta. In many cases of impaction a patient makesviolent efforts to hawk up the foreign body and so produces aphonia. Theremay be violent retching. Even after a foreign body has been removed by swal-lowing, by vomiting, or by surgical extraction a sensation is apt to remain as 942 Diseases and Injuries of the Upper Digestive Tract if the body were still lodged. The diagnosis is made by the history, the detec-tion of the body by external manipulation, by feeling it with an esophagealbougie, by esophagoscopy, and, if bone or metal, seeing it with the fiuoroscopeor obtaining a skiagraph. Treatment.—The surgeon should learn, if possible, the size, shape, weight,an
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