received a dose of morphine and cocaine, the cough
reflex was not affected locally, Lotrel 10 and an extremely
irritating cough from which she had suffered for a
long time persisted during the entire operation.
Case II. A girl aged sixteen referred by Dr.
William Dougherty of New York. The girl gave
a history of having swallowed a shawl pin some
five days before and had no cough or discomfort
after it had disappeared. Lotrel 5 A radiographic picture
taken by Dr. George S. Dixon showed the pin to
be located in the upper cervical region. There was
considerable swelling of the neck of the patient and
she complained of pain in her throat from an
attempted removal before admission. The patient
had some difficulty in swallowing. The patient was
prepared for an esophagoscopic examination Purchase Lotrel and
the spatula esophagoscope was introduced without
anesthesia. There was no pin in the larynx. There
was a long rip in the cricopharyngeous constrictor
and esophageal wall and the swelling we had noted
in the neck was due to subcutaneous emphysema,
no foreign body was visible. As the pin had dis- Lotrel Cost
appeared the patient was sent again to the radio-
graphic room and another picture taken of the entire
chest and abdomen.
The chest plate showed the pin to be lodged in
the Buy Lotrel Online left bronchus with Lotrel 510 the point in the upper lobe
orifice. As the patient was in a very poor condi-
tion from the esophageal rupture no anesthetic was
l-iG. .S, — Lotrel Mg (Case I.) X ray picture showing shadow of shawl pin.
used. A dose of morphine was administered and the
pin was rapidly removed through a seven mm. tube.
The point of the pin was in the left upper lobe
bronchus, but Lotrel Online it was easily pushed downward after
grasping the shaft with forceps and disengaged. The
removal of the pin from the bronchus taking three
minutes. After the removal of the Discount Lotrel Lotrel Coupon pin the esoph-
agus was inspected.
October 30, 1920.]
LVXAH: FOREIGN BODIES.
655
There was a long slit in the esophagus, the edges
of Order Lotrel the wound were covered with a thick slough. A
suction tube was introduced into the wound and
with a twenty inch vacuum some foul smelling
material was removed. The wound was then
swabbed with tincture of iodine. As the patient
Fig. 4. — Shawl pin in the larynx supposed to be in the upper
esophagus. Radiographic plate taken before attempted removal from
the esophagus. (Case II.)
had Cheap Lotrel been unable to swallow for the past twenty-
four hours and was suttering from water hunger,
milk and water were injected by syringe into the
stomach through the esophagoscope. A soft rubber
stomach tube was then introduced and the patient
fed by the sj'ringe method through the proximal
end of the tube which extended out of her mouth.
The tube was attached to the neck by tape to prevent
its becoming dislodged and swallowed. By this time
there was marked emphysema of the neck and face
and the temperature had risen to 103.2" F. Buy Lotrel The
pulse was weak and rapid. The patient was at all
times conscious, and her chief complaint was a severe
stabbing pain in the region of the sternum on Lotrel 5 Mg inspi-
ration. There was a booming systolic heart sound
over the entire precordial Lotrel Price region. The second soimd
could not be elicited. Scattered rales were elicited
over the anterior aspect Lotrel Coupons of the chest, but these were
probably due Lotrel 20 Mg to the crackles of the subcutaneous
emphysema in this area. The following day after
a thorough dose of the water cure treatment, the
patient requested that the tube be removed. This
was done Lotrel 10 Mg and the wound in the esophagus was again
swabbed with iodine after thorough evacuation of
the pocket. The feeding tube was then replaced.
This treatment was continued from day to day and
by the end of the first week the patient showed
signs of improvement. The temperature was 101.4°,
pulse 110 and regular and respirations 32. There
was a pleuritic rub over the -region of the sternum
but the heart sounds could be distinctly heard. By
the tenth day the patient continued to show improve-
ment but strenuously objected to the Lotrel 10 20 method of
feeding. The esophagoscope was passed and the
wound inspected. The woimd had almost com-
pletely healed but there was still an inflammatory
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