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November 20, 1948


Author Affiliations

Los Angeles

From the Department of Medicine, College of Medical Evangelists, Los Angeles.; Fellow of the American College of Physicians.

JAMA. 1948;138(12):885-887. doi:10.1001/jama.1948.62900120001007a

For a long time internists and surgeons have desired to possess an instrument with which the esophagus might be inspected safely and clearly. Esophagitis, a frequent cause of distress (Winkelstein), can be diagnosed only by direct inspection of the inflamed mucosa. Early carcinoma of the esophagus easily escapes roentgenologic detection.

DISADVANTAGES OF ESOPHAGOSCOPES NOW IN USE  The present esophagoscopes are not safe. Mastery of their use requires long study, but even in the hands of the most expert examiner occasional mishaps occur. The most frequent lesion is a hypopharyngeal tear, often leading to mediastinitis and death. Usually it is assumed that esophagoscopy has a morbidity rate of 2 per cent and a mortality rate of 0.5 per cent. These figures would rise considerably if esophagoscopy were to be done by any other than trained experts. The existing dangers attending esophagoscopic examination often prevent the most conscientious physicians from referring their