84 



CAXINE AND l-ELINE SURGERY. 



oi- probang, the cesophagus must be incised. If this is not 

 done ulceration may take place, or the foreign body may cau.se 

 dilatation and form a pouch for itself, the result usually being- 

 great pain, emaciation, and, ultimately, death. The mo.st com- 

 mon seats at which obstructions occur are just before the gullet 

 passes into the thorax, and in the thoracic portion just before 

 the cesophagus passes through the diaphragm. In the latter 

 case it is sometimes necessary to perform laparo-gastrotomy, 

 and, by the aid of a pair of thin forceps passed through the 

 cardiac orifice of the stomach to reach the foreign body from 

 behind. The operation upon the upper portion of the oeso- 

 phagus is performed as follows.^ 



Fig. 50. 

 Showing two patterns of probang. 



Place the patient in the dorsal position with the neck well 

 extended so as to expose the throat ; anaesthetise with some 

 local aiipesthetic, and incise the skin directly over the obstruc- 

 tion as near the centre as possible ; apply pressure forceps to 

 alUvy h;emorrhage, push aside any vessels in the vicinity, and 

 expose the oesophagus. This organ is then incised longi- 

 tudinally by a clean, bold cut, and the foreign body removed 

 with forceps. At this stage vomiting sometimes occurs. The 

 wound and surrounding parts are then thoroughly cleansed 

 and disinfected, and the cesophagus is sutured through all the 

 coats at the same time, the muscles and skin being then closed 



^ ".Journal of Comparative Pathology and Therapeutics," Vol. X., p. 3nS, 



