228 Obstruction of the Esopliaj,nis. 



gressive and rapid emaciation becomes noticeahle and tlie wall 

 of the esophagns which is compressed by the foreign Ixxly be- 

 comes necrotic. If the necrotic portion of the wall breaks into 

 the surrounding tissues, the clinical picture terminates by a 

 purulent or ichorous inflammation of the cervical connective 

 tissue or, if the thoracic portion of the esophagus is involved, 

 by a pleuritis. Inflannnation and gangrene of the esophageal 

 wall develops rapidly if the wall has been injured and a channel 

 for infection has been opened up. Injuries produced by the 

 introduction of the esophageal sound and in attempts at remov- 

 ing the foreign body may have the same effect. 



Obstruction caused by morsels of food may, without veter- 

 inary interference, be recovered from speedily, i. e., if the mor- 

 sel becomes softened and if it can then be removed. If, on the 

 other hand, the morsel dries and becomes harder, it may pro- 

 duce dilatation or perforation with grave consequences. A 

 fatal issue may, however, occur occasionally after removal of 

 the foreign body into the stomach, if artificial feeding has been 

 neglected (Drouin) or if an intense inflammation of the esoph- 

 agus has occurred and now of itself causes intense difficulty in 

 deglutition (Johne). Difficulties in deglutition and vomiting 

 may, especially in the horse, lead to pulmonary gangrene from 

 the start. In greedy horses, obstruction of the esophagus by 

 too large morsels may recur repeatedly within a short time. 



(Small, pointed bodies frequently perforate the wall of the esoph- 

 agus and become encapsulated in the neighboring tissues witliout pro- 

 ducing any marked disturbances [Bruckmiiller, Kitt].) 



Diagnosis. In obstruction of the esophagus by lodgment 

 of a foreign body we can usually get a proper clinical history 

 and we have the sudden appearance of the grave disturbances 

 of deglutition. If the obstruction has occurred in the cervical 

 portion of the esophagus, a reliable diagnosis can be made by 

 palpation from the outside or from the pharynx. In other 

 cases, particularly if the obstruction is in the thoracic portion, 

 the diagnosis may meet with considerable difficulties. Spasm 

 of the esophagus can be distinguished from the milder rapidly 

 recovering cases of obstruction by the use of the sound, which 

 must sometimes be preceded by the administration of narcotics 

 (see page 223). 



Stenosis or dilation of the esophagus may be excluded from 

 the clinical history and from the observation, that soft feed and, 

 still more, fluids will pass the giillet without difficulty some 

 time after feeding. In paralysis of the esophagiis, forced at- 

 tempts at deglutition and gagging are absent. 



In ruminants, acute meteorism, due to some other cause, 

 might erroneously be referred to obstruction of the esophagus ; 

 but if not due to the latter condition, there is no disturbance 

 and no regurgitation, and the sound meets no impediment in 



