Esophagoscopy

Abstract

Practically all lesions of the esophagus have one outstanding symptom in common,—dysphagia—and it is because of this that patients seek the advice of a physician. The name esophagus is derived from the Greek and means to carry food. This is its sole function. Any lesion which interferes with its normal function produces dysphagia. A puncturing injury or an ulcerating lesion may lead to mediastinitis, a tracheo-esophageal or broncho-esophageal fistula or to a fatal hemorrhage.

The only ways by which the esophagus may be visualized are by the use of the roentgen rays and barium meal and by the use of the esophago-scope. The first should always be used. In the majority of cases this should be supplemented by esophagoscopy. Esophagoscopy has a twofold use. First, it is a diagnostic aid of proved value. By its use the entire length of the esophagus can be inspected, and lesions which may be too small to be visualized by roentgen examination can be seen. Biopsy specimens can be removed for pathologic examination and diagnosis. Secondly, it can be used for treatment. The most important use in this respect is the removal of foreign bodies. Local treatments can also be given when they are indicated.

The procedure is attended by little danger when it is done by a careful and experienced operator. Rough handling and the use of too much force may produce a rupture in the thin wall of the esophagus and lead to a fatal mediastinitis. The point where the. . .