STRICTURE OF THE ESOPHAGUS 135 



is very long, one or more interrupted sutures should be made 

 in the esophagus and the wound packed with gauze saturated 

 in a boric acid solution (2 per cent.), retained with sutures 

 through the skin. Allow this to remain in position for 

 twenty-four to forty-eight hours, then remove pack, the 

 sutures in the esophageal wall and treat as an open wound, 

 cleansing it daily with boric acid solution (2 per cent.) until 

 healing is complete. Withhold all food and drink for twenty- 

 four hours and then give only liquid foods for a few days. 

 Rectal feeding of milk, eggs, etc., may be used when the 

 swelling of the mucous membrane is sufficient to obstruct 

 the esophagus. 



(e) As a last resort when the firmly fixed object is located 

 in the thoracic portion of the esophagus and cannot be 

 removed by the methods mentioned, gastrotomy should be 

 performed (see Diseases of Stomach), and the catheter 

 introduced to propel the foreign body out via the mouth. 

 Should the object be located in the cardiac portion of the 

 esophagus, a small dressing forceps is often useful to grasp it 

 and remove it via stomach incision. 



ESOPHAGISMUS. 



Definition. A spasmodic contraction of the esophagus. . 



Etiology. This condition occurs occasionally during the 

 course of some diseases. It has been observed in chorea, 

 epilepsy and in the early stages of rabies. Sometimes foreign 

 bodies, by irritating the membranes, produce a spasmodic 

 contraction of the walls of the esophagus. 



Symptoms. Very similar to foreign bodies in the esophagus; 

 often foreign bodies are also present. 



Prognosis. In most cases favorable. 



Treatment. The passage of the sound is usually sufficient 

 to overcome the condition except in the case of foreign bodies 

 being present. (See Foreign Bodies in the Esophagus.) 



STRICTURE OF THE ESOPHAGUS. 



Definition. A constriction of the esophagus due in most 

 cases to cicatricial contraction of the walls reducing the size 

 of the lumen. 



