Shows the external layers of the esophagus closed by interrupted Lembert suture of silk. (Richardson.)
Traction diverticula may be amenable to surgical intervention. Should the esophagus be diverted by adhesion to an advancing aneurysm nothing should be attempted. Among the operations which may be practised upon the thorax there may be mentioned a method of posterior exposure and attack upon some of these conditions which may or may not afford advantages, according to the nature and location of the various conditions.
Cardiospasm (see chapter on the [Stomach]) produces a sacculation of the gullet often mistaken for diverticulum, and requiring to be differentiated from it.
FOREIGN BODIES IN THE ESOPHAGUS.
Foreign bodies may be lodged in any portion of the esophageal tube and cause a variety of troubles, according to their size, shape, location, and nature. There is scarcely any conceivable object which may be introduced into the mouth which has not been known to be impacted in the esophagus and produce more or less serious symptoms. Young children, imbeciles, and the insane may suffer unwittingly in this way, while the condition is usually accidental and unintentional.
The accompanying figures ([Figs. 513] and [514]), portraying in one case a jackstone lodged in the esophagus, a coin in the other, a case of my own, will furnish illustrations of what has just been said. (See also [page 674].) The young and the insane may make no statement which will furnish a clue for the distress caused in attempts to swallow or the actual impossibilities of the act. In most instances, however, a history of impaction and a statement as to the nature of the foreign body may be obtained. The symptoms produced are those of partial or complete inability to swallow, of more or less pain accompanying the act, and of the regurgitation often of blood or of bloody mucus. The object may be sufficiently large to produce dyspnea and suffocative symptoms, e. g., a plate with false teeth.
Fig. 513
Jackstone lodged in esophagus. (Phelps.)