The Diagnosis of Surgical Diseases

Cover The Diagnosis of Surgical Diseases
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Swelling of the glands is rare; fragments of the growth, available for microscopical examina- tion, are never encountered. And yet the diagnosis is made with a probability bordering on certainty. Hav- ing heard the patient's history, and having demon- strated a stricture by means of bougies, we reason as follows: The patient is of the age at which carcinoma of the esophagus commonly occurs. The stricture has no known cause in other words, it is spontaneous. Its course has been so rapidly progre...ssive that carcinoma alone could account for it; besides, the patient gives no evidence of other disease. Of course, one other com- DYSPHAGIA STENOSIS OF THE ESOPHAGUS 117 plaint must be ruled out: this is compression of the esophagus by a tumour.
Carcinoma of the esophagus can develop at various parts of the tube. It is most often found at the lower end ; or, more accurately, it is found ofteiiest at any part of the esophagus which is below the upper border of the thorax.
If the obstacle is situated at the level of the cricoid cartilage, we must bear in mind those rare cases of enlargement of the lamina of the cricoid which are sometimes met with.


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