Customize your JAMA Network experience by selecting one or more topics from the list below.
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
The necessity of using a guide for the passage of esophageal dilators, when dilation is done by so-called blind bouginage (i. e., without direct visualization through the esophagoscope) has been recognized. Plummer and Mixter have advised the swallowing of many feet of thread in the hope that this will have passed the obstruction and become entwined in the intestine; the thread held taut may then be used as a guide by inserting it into a suitable opening in the tip of the dilating instrument. In spite of the physician's most painstaking instructions and the cooperation of an intelligent patient, this often fails to pass the obstruction or becomes knotted and is thus useless for the passing of the instrument. Such difficulties are found more particularly in cardiospasm, in which the thread becomes enmeshed in the sac oral to the obstruction.
It is well known that the old-fashioned stomach tube (Ewald
Davidson PB, Biguria F. A SIMPLIFIED GUIDE FOR THE PASSAGE OF ESOPHAGEAL DILATORS. JAMA. 1932;99(13):1084–1085. doi:10.1001/jama.1932.27410650001011a
Create a personal account or sign in to: