Two uncommon esophageal cases / Anthony Bassler, M.D.

  • Bassler, Anthony, 1874-
Date:
1913
Catalogue details

Licence: In copyright

Credit: Two uncommon esophageal cases / Anthony Bassler, M.D. Source: Wellcome Collection.

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    then retracted to the' right. The carotid sheath was next iden¬ tified and retracted to the left. An esophageal bougie was then passed. At a point as deep in the neck as possible, the esophagus was seized with volsallum forceps and a longitudinal slit made over the bougie. The bougie was. then withdrawn and the finger inserted into the esophageal wound. The plate was located apparently opposite the second costosternal junc¬ tion, its base directed upward with the angle on the left side firmly imbedded in the esophagus. This projecting angle was broken off and removed with a pair of forceps, after which the plate was readily extracted. The wound was then lightly packed with gauze and patient returned to bed. For nine days the patient was nourished by rectum and kept sitting up in bed, and dressings were changed daily. On the tenth day the patient was given liquids by mouth and, there being no escape through the esophageal wound, nourishment continued to be given this way. His convalescence was uneventful in every way.” The second case is of interest in showing a type of esophageal obstruction which has not been recognized as yet and which accounted for a peculiar swallowing symptom. Case 2.—Mr. C. Id. S. (referred by Dr. Stephen Lee, East Orange, N. J.), aged 78, married, manufacturer, family his¬ tory negative, at the age of 30 noticed a swelling in the root of his neck on the right side. This was diagnosed by Dr. Willard Parker and Dr. Sands as an aneurvsm of the sub- »/ clavian artery for which nothing was done, and the growth has not enlarged in the last forty-eight years. The patient took exceptionally good care of himself in the way of diet, exercise, sleep, etc. About five years ago he noticed a stinging and distressing sensation in the right chest when he swallowed acid food or drink. This was particularly noticeable when he drank lemon¬ ade or ate stewed tomatoes. This stinging sensation, when prominent, gave him flashes of distress down the left arm. He stated that he had no distress excepting when he partook of acid things, and then only for from five to ten minutes after he had swallowed, that partaking of these acid things did not cause him distress in the stomach, and that such distress as he had was entirely substernal. Examination revealed a tall, thin type of man with an aneurysm of the second portion of the subclavian artery on the right side of the size of a small peach. No radial pulse was palpable on the right side. Blood-pressure, systolic, 186; diastolic, 100. Distinct atheroma of the right brachial. Urine contained increased amounts of ii.dican, no albumin or casts.