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• W1765792334 abstract "THIS report is based on the study of sixty patients suffering from obstruction of the esophagus. The three principal causes were cicatricial stenosis, spastic stenosis and malignancy, the obstruction varying from partial to complete. Three cases of compression stenosis are included which are typical of partial obstruction of extrinsic origin; namely, one due to goiter, one to aneurysm (Fig. 1) and one to enlarged mediastinal glands. Only one foreign body case is included and this is classified with the cicatricial stenosis group because of the large amount of scar tissue that followed the trauma of the early attempts to remove it. Twelve of the series were cicatricial, ten spastic and thirty-five malignant in origin. The origin of the scar tissue in the cicatricial group corresponds fairly well with the large variety of causes in this class of stenosis. Four were due to drinking some corrosive (Fig. 2), one phenol, one followed a typhoid ulcer. One constriction was considered at first to be malignant but later found to be due to extensive induration of gastric ulcer located high on the fundus. The patient has lived more than a year and has greatly improved since his gastrostomy (Fig. 3). Lues was not recognized as the cause of any constriction. It is a rare condition. However, one must always give the patient the benefit of a Wassermann and the usual anti-syphilitic treatment if there is no history of trauma and the constriction is smooth in outline. Obstruction from a foreign body is usually temporary. However, sufficient traumatism may occur from an irregularly shaped object, or from attempts to remove it, to cause scar tissue formation and a firm stenosis. The patient included in this series is a little girl, nine years of age, who swallowed a jackstone (Fig. 5A). Attempts to remove it being unsuccessful, after about three weeks she was taken to Dr. Jackson in Philadelphia. Two weeks later, after carefully dilating several constrictions, the foreign body was finally uncovered and removed. A gastrostomy, followed by guided bouginage, has given a good lumen (Fig. 5B). Spastic stenosis as encountered in this series is limited to the lower portion of the esophagus. All ten cases can best be referred to as cardiospasm. All of them lived long enough—two to ten years—to rule out an associated malignancy. All have responded to the forceful stretching of the musculature, with the exception of one, not treated. One required a gastrostomy and digital stretching of the cardia, as described by Walton (Ref. 5, Fig. 7). No ill effects have been obtained. Two gained sixty pounds, one gained eighty. Rapid eating or the gulping of food are considered predisposing factors in cardiospasm. The youngest patient was sixteen and the oldest seventy-eight. One of the ten had a severe hemorrhage the second day after the X-ray examination, followed after a few days by a gastrostomy." @default.
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• W1765792334 date "1925-10-01" @default.
• W1765792334 modified "2023-09-26" @default.
• W1765792334 title "Obstruction of the Esophagus" @default.
• W1765792334 doi "https://doi.org/10.1148/5.4.312" @default.
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