Herman J. Moersch

Carcinoma of the esophagus and cardia; results of treatment, 1946 to 1956.

RESECTIVE surgery for carcinoma of the esophagus and cardia can now be carried out with a reasonably low mortality. Opinion varies, however, over whether this form of treatment benefits the patient...

CII. Diffuse Spasm of the Lower Part of the Esophagus

Esophageal obstruction of neurogenic origin constitutes one of the most interesting phases of esophageal disease. Much has been written regarding this interesting problem, and although considerable progress has been made in dealing with it, there remains a very fertile field for further investigative effort. Localized spasm of the esophagus, cardiospasm and Barsony diverticula constitute the better known of these conditions.

XC Esophageal Defects in Dermatomyositis

Dermatomyositis is a relatively rare, nonsuppurative, nonhemorrhagic type of polymyositis in which cutaneous changes usually occur. In some instances involvement of the skin may be transient or comxad pletely absent, in which case the term polymyositis is applied. The primary pathologic change occurring in muscle is an inflammatory reaction followed by granulation and hyaline degeneration. The pathxad ology of the skin lesions is nonspecific. Scleroderma, with edema and Raynauds changes, and systemic lupus erytheratosus, with chronic skin lesions, clinically may simulate forms of dermatomyositis and give rise to such terms as sclerodermatomyositis and Poikilodermaxad tomyositis respectively. Dermatomyositis and scleroderma may simxad ulate other diseases involving the esophagus and must be differentiated from such conditions as central nervous system disease, malignant tumors and achalasia, as well as from each other. In the absence of well-defined skin lesions, the clinical diagnosis may be obscured by the diffuse symptomatology and nutritional deficiency.

LVII Hiatal Hernia

Diaphragmatic hernia has been a source of interest to the medical profession for many years. The earlier studies dealing with this problem dealt primarily with hernia occurring as a result of trauma, or hernia of congenital origin developing through the anatomic points of weakness existing in the diaphragm. With the improvement in roentgenographic technique, it became increasingly apparent that the most frequent site for diaphragmatic herniation was through the esophageal hiatus. The herniation of part or all of the stomach through the esophageal hiatus may give rise to many bizarre clinical manifestations. Increasing experience has taught that esophagoscopy may be of the utmost importance in a proper evaluation of such symptoms and it may be an important factor in the differential diagnosis of the type of hernia and a guide in treatment.

CVII Resection and Anastomosis of the Trachea: An Experimental Study

The purpose of this report is to describe the results one and one-half to two and one-third years after resection of a portion of the trachea in a series of 7 dogs. In a previous report we related our early studies on resection of the trachea. In that report! early data on the present series of dogs were included. At the time of the first report this series of dogs had been observed for two and one-half to thirteen months.

XLI. Impermeable Cicatricial Stricture of the Esophagus Treated by a Modification of the Iglauer Technic

The treatment of impermeable cicatricial stricture of the esophagus .constitutes a very serious endoscopic and surgical problem. Fortunately it is not a common complication. It is, however, one that must be carefully guarded against in every case of benign cicatricial stenosis of the esophagus. It is most likely to develop as a result of neglect, but it may develop as the result of inadequate treatment. One of the most common therapeutic errors is the tendency to regard gastrostomy as the first and only procedure in the treatment of benign cicatricial stricture of the esophagus, disregarding the necessity of maintaining a patent esophageal lumen.

LXXIV. Tracheal and Esophageal Compression as a Result of Adenomatous Goiter

Compression of the esophagus and of the trachea were formerly frequently mentioned in the literature as complications of adenomatous goiter. In earlier literature are numerous instances of patients with adenomatous goiter, who, although apparently in good health, suddenly expired as a result of tracheal compression. One of the tragic experiences of the pioneer surgeons, when operating on the thyroid gland, was that of sudden death from this complication in the course of the operation. Although compression of the trachea and of the esophagus may be produced by other types of disease of the thyroid gland, especially carcinoma, this paper will be limited to compression produced by adenomatous goiter. .::