Other complications include septic broncho-pneumonia from damage to the air-passage, and suppurative thyreoiditis.
Infective conditions due to pyogenic infection (œsophagitis and peri-œsophagitis) are rare.
A chronic form of œsophagitis is occasionally met with in alcoholic subjects, giving rise to symptoms that simulate those of impacted foreign body, or of stricture.
In tuberculous lesions the symptoms are pain, dysphagia, and regurgitation of food mixed with blood, and the condition is liable to be mistaken for gastric ulcer or for cancer of the œsophagus.
Syphilitic affections of the œsophagus are rare.
Varix at the lower end of the œsophagus may give rise to hæmatemesis, and be mistaken for gastric ulcer. Bleeding from the dilated veins may follow the use of bougies or of the œsophagoscope.
Conditions causing Difficulty in Swallowing
Difficulty in swallowing may arise from a wide variety of causes which it is convenient to consider together.
Impaction of Foreign Bodies has already been discussed, and attention has been drawn to the importance of the history given by the patient and to the various sources of fallacy or deception—in children it may be artful reticence or misrepresentation, in adults, the possibility of nightmare and of dreams.
Compression of the Gullet from without.—Any one of the numerous structures in relation to the gullet may, when enlarged as a result of disease, give rise to narrowing of its lumen, for example a lymph-sarcoma at the root of the lung, or any enlargement of the thyreoid or of the mediastinal lymph glands. The possibility of aneurysm must always be kept in mind because of the risk attending the passage of instruments for diagnostic purposes.