Peroral endoscopy and laryngeal surgery . a long-standing case, mighteasily have resulted from erosion and ulceration following the esopha-gitis due to stagnation. Undoubtedly after a diverticulum has developedto a certain degree there exists a vicious circle, that is the food inthe pendulous portion presses on the sulxliverticular portion of theesophagus and thus increases the difticully of swallowing, and conse- DISITASKS OF TIIK KSfilMIACIS. 543 (liR-ntly increases stenosis, with consec|uent increased pressure upon theI)oucli. Irf)m excessive activity the ol)lii|uc fibers may hypertrophy. I
Peroral endoscopy and laryngeal surgery . a long-standing case, mighteasily have resulted from erosion and ulceration following the esopha-gitis due to stagnation. Undoubtedly after a diverticulum has developedto a certain degree there exists a vicious circle, that is the food inthe pendulous portion presses on the sulxliverticular portion of theesophagus and thus increases the difticully of swallowing, and conse- DISITASKS OF TIIK KSfilMIACIS. 543 (liR-ntly increases stenosis, with consec|uent increased pressure upon theI)oucli. Irf)m excessive activity the ol)lii|uc fibers may hypertrophy. Itis thus clear that all that is needed is to get a start; later, even thoughthe causes which originally started the trouble should disappear, thediverticulum will perjietuate itself and continue to increase in size. ( and i-ir,). Proiinosis. Lntreated pressure diverticula Ijecause of the abovementioned vicious circle probably always increase steadily in size andconse(|uently in distressing symptoms. This is shown in the two radio-. FiG. 423.—Bismuth radiograph illustrating normal swallowing. Tlie bismuthmixture is seen in the pyriform sinuses, D, E. .\t A and C is seen the bismuthmixture in process of swallowing while the cricoid cartilage is in close contactwith the posterior pharyngoesophageal wall. graphs of one of the authors patients who declined operation. (^l and A2-)). The history of this case follows: Male, aged 4() years, referred to the author by Dr. T. \). stated that trouble in swallowing and spitting u[) of food begansuddenly after he felt something give way during a violent attack ofcoughing. Cough had persisted since. Loss of weight six showed a small pouch extending outward slightlv to theleft. The cricopharyngeal fold was quite aciUch- in flanimator\- anil thepouch showed chronic esophagitis. The subdixerticular opening was anarrow slit. It admitted a 7 mm. esojihagoscope readily, but the adultsize (111 mm. I
Size: 1973px × 1266px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectrespira, bookyear1915
