Case of fatal hemorrhage from perforation of the aorta by false teeth impacted in the oesophagus / [James Duncan].

  • Duncan, James, 1810-1849
Date:
1844]
Catalogue details

Licence: Public Domain Mark

Credit: Case of fatal hemorrhage from perforation of the aorta by false teeth impacted in the oesophagus / [James Duncan]. Source: Wellcome Collection.

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    conceive a more dangerous weapon, or one more likely to be followed by fatal consequences, than that I have just described, when lodged in the situation in which this one must have re¬ mained from the time of the accident, in order to have produced the extent of ulceration met with on dissection. Its form readily explains how it could not be felt, on the second introduction of the probang, and offered no resistance to the passage of the in¬ strument downwards. From the curve which it describes, and from the stretching of the oesophagus between its two terminal points, ample space must have been left for the passing of the instrument; and from the manner in which it must have got impacted after the first passing of the probang, it would present superiorly an edge not much exceeding in thickness that of an ordinary sheet of writing-paper, so that the bulb would readily glide over it without any resistance being met with. In every point of view the case was an exceedingly alarming one. If the teeth were allowed to remain in the oesophagus, they could scarcely fail to induce fatal consequences ; and if they passed into the stomach, the result would in all probability have been the same, although very dangerous bodies are recorded as having passed the wThole length of the intestinal canal without injury. Even had they been within reach of the forceps and grasped by them, or had they been entangled by the threads attached to the probang, their removal must have been attended with very great danger, and might have proved instantaneously fatal from the laceration of the important parts in the vicinity. This case also affords an instructive example of one of the many modes in which foreign bodies lodged in the oesophagus may prove fatal, and inculcates the necessity of removing them as early as possible when their removal can be effected. Foreign bodies lodged in the oesophagus may lead to fatal conse¬ quences in a variety of ways. When large, the first danger to be dreaded is that of suffocation : this may take place instantaneously before assistance can be afforded, and many cases are recorded in which death has been produced in this manner. Should the foreign body not be so large as to induce asphyxia, but remain impacted in the oesophagus, various other results may follow. Inflammation of the surrounding parts, leading to suppuration, may supervene, and the foreign body thus being set free, may cither descend into the stomach, or may be rejected by the mouth along with the purulent matter. Extensive suppuration of the surrounding soft parts may on the other hand take place, and may. as has