US 3302634 A
Description (OCR text may contain errors)
Feb. 7, 1967 3,302,634
INFLATABLE STRING FOR MARKING INTERNAL BLEEDING M. w. MAZELLAN Filed Sept. 13, 1963 INVENTOR. MYRON W. MaZELLn/v ATTOQ/V Y United States Patent O 3,302,634 INFLATABLE STRING FOR MARKING INTERNAL BLEEDING Myron W. Mazellan, 517 Milltown Road, North Brunswick, NJ. 08846 Filed Sept. 13, 1963, Ser. No. 308,866 Claims. (Cl. 128-2) This invention deals with an inflatable string to be swallowed =by a patient for locating the area of gastrointestinal tract in which bleeding is taking place. More specifically, it relates to an orally-introduced string comprising an elongated, narrow, inflatable, sausage-like string, made of radio-transparent fil-m, of plastic or similar material, and coated or covered with similarly-transparent blood-absorbent material, and having X-ray opaque markings thereon or therewith, for pin-pointing the bleeding area.
There is described in Patent 3,097,636 a string for marking internal bleeding, consisting of an absorbent tape having a weighted, orally-insertable end, and carrying radio-opaque markers. Such a tape, which is non-fluorescing under ultra-violet light, is swallowed by the patient, with the aid of sips of water. Once the weighted end reaches the stomach, the patient is instructed to continue swallowing segments of the tape, until the required length of string has entered the gastro-intestinal tract. Thereafter, a roentgenogram of the upper abdomen is taken to clearly outline the characteristic C-loop of the abdomen.y Then, while the patient is lying on the X-ray table, a dose of fluorescein dye is injected into an antecubital vein, and the dye is allowed to circulate for four minutes before the str-ing is pulled out of the patients mouth. Gloves are worn prior to withdrawal of the string 4to reduce the danger of possible contamination with dyed lingers. After the string is removed, it is examined under ultra-violet light for fluorescence. If the patient has been bleeding actively at the time of the test, both blood and fluorescence will be readily located on the tape. The dye is visible as a yellow spot on the tape when examined under ultra-violet light, and the situs of the bleeding is pin-pointed by counting back the number of markers from the weighted end, and comparing this with the roentgenogram. Use of such a string has been successful .in locating the bleeding site within a distance of one or two inches.
There have been some diflculties encountered with the use of such a string, including the swallowing of the limp tape, particularly by children and persons unable to swallow `because of profuse bleeding, for example, and because of the highly limber land laccid nature =of the tape. One method for avoiding such difliculties is in the use of a semi-rigid flexible core, such `as a plastic tube, within or attached to the tape. Such `a unit can be introduced by the physician, thus saving time.
As already mentioned, the duodenum contains the upper abdominal C-loop which readily allows passage therethrough of a tape, but does not permit passage within a rapid time, without possible damage thereto, of a rigid material. Once passage is effected past this C-loop, there is 4little difllculty :of further passage of even a limp tape. An ideal string, therefore, would be one which is semi-rigid and flexible until it is swallowed up to the C-loop (since it is much easier to force d-own such a string, rather than a -limpid one), after which it would become limpid, since the limpid string voffers the minimum of discomfort and resistance to remove out of the gastro-intestinal tract.
An object of the present invention is to provide a string which can be swallowed in inflated form and then deflated. The invention will ybe more readily understood by reference to the accompanying drawing in which a .preferred embodiment is described, and in which FIG- URE 1 illustrates a side view, with upper tape portion partly cut open or torn away, of a deflated string of the present invention. An enlarged cross-sectional View taken along line 2 2 in FIGURE 1 is shown in FIG- URE 2. FIGURE 3 depicts the View shown in FIG- URE 2, in inflated condition, while FIGURE 4 is a similar View of another embodiment of the invention, in deflated condition. A similar view of still another embodiment, in deflated condition, is depicted in FIGURE 5. FIGURE 6 presents an enlarged vertical cross-sectional view of a portion of an articulated string, in inflated condi-tion. Similar numerals refer to similar parts in the Various figures.
Referring again to the drawing, numeral 10 indicates generally a string of the present invention comprising an elongated radio-transparent, continuous, thin-walled, inflatable, flexible tube 11, in collapsed condition, and made of any suitable material, such as polyethylene, polyvinyl chloride, fluoropolyme-r, and the like. This tube is sealed rofl at its swallowing end l2, whereas its upper held end 13 is cemented, or otherwise attached, to plastic tip 14 having inlet 23 through which air may be introduced by blowing, insertion of a syringe-type bulb, an air bulb having a one-way valve, or the like, for the purpose of inflating tube 11.
Around tube 11 is coated, or woven, a radio-transparent absorbent cover 15, which may be of a single piece woven around tube 11, or may consist of two clot-h tapes 15 and 15, sewn together at the edges, as at 16, it being understood that the sewing is done carefully enough so as not to puncture tube 11. Cover 15 is sewn at end 17, and anchored to closed end 12 of tube 11 by cement, cord, 4or the like, or sewn onto an appendage of the plastic tube. Also, upper end 18 of cover 15 is attached to the lower end of top 14 in a similar manner.
If two tapes, 15 and 15 are employed for the cover, the radio-opaque markers 19 are best attached to the inner surface `of a tape, such as tape 15', by cementing, heatsealing, or by any yother means, the markers being in the form of a radio-opaque thermoplastic sheet. Also, visible, non-fluorescing and non-toxic markers, such as lines 20, or thread of another color, may be applied to the outer surface of tape 15', in juxtaposition with markers 19, to facilitate orientation of the bleeding spot with respect to the end of the string.
When in use, the string is first soaked in cold water, and is then inflated through tip 14. If a one-way valve air -bulb is not employed, the inflated string may be clamped with a clamp near the upper portion 13 of the tube, so as to keep the string inflated while it is being swallowed by or inserted into the patient. After the string has been swallowed for the required distance, the tube is deflated to enable it to proceed past the duodenum and C-loop, and thereafter removed in deflated condition.
An articulated tube such as tube 11a in FIGURE 6 is particularly advantageous because it can be bent (e.g., while passing through curvatures) much more readily than a continuous tube which has a tendency to straighten out. This articulated tube comprises inflatable spherical or cylindrical sections 11b connected with narrow tubular sections 11C.
In FIGURE 4, there is shown a deflated inflatable `tube 11, having cemented or otherwise attached to one side, at 21, a cloth or other similar absorbent layer 15a. The radio-opaque markers 19 are disposed between t-he tube wall and the cover. If desired, the other side of tube 11 also may be similarly coated with a layer 15b of absorbent material.
FIGURE 5 discloses a cloth tube 15e, the inner surface of which is coated with a layer 22 of gas-impermeable material, such as rubber or plastic. In this case, the cloth tube itself may be inllated, and its outer surface llSd is adequately absorbent for string use. Markers I9, in this case, may be cemented to 4the inside surface of the tube. Provision for an air inlet, such as -tip I4, and a sealing of the swallowed end would be made, as in FIGURE l.
The string Ill may be made in 30" and 50 lengths, while Kthe inflatable tube may have an outside diameter of 5/32" or 7/32 (in two separate sizes), with a wall 0.0001- 0.0004 inch, more lor less, the tube being tree of 'any rigidity when in inflated condition.
Although the strings of the present invention are adapted to be generally inated with a gas, it is to be understood that ination with `liquids may be partially or completely effected and shall be considered the equivalent of gasination.
I. In a blood-absorbing string taken orally for locating bleeding in the ygastro-intestinal tract, as described, and provided with radio-opaque markers along the length thereof, the improvement comprising a continuous, radio-transparent elongated, collapsible thin-walled tube, serving as .the core for the string, and
having an open end and a swallowable closed end,
a layer of absorbent, radio-transparent material attached to the outside of said tube, and
inflation medium-receiving means attached to the open end of said tube.
2. In a blood-absorbent string taken orally for locating bleeding in the gastro-intestinal tract, as described, `and provided with radio-opaque markers along the length thereof, the improvement comprising:
a continuous, radio-transparent, elongated, collapsible thin-walled eXible tube, serving as the `core for the string, and having an open end and a swallowable closed end, and a cover of absorbent, radio-transparent material attached to the outside of said tube and serving as an 5 expansion-limiting means for said tube.
3. A blood-absorbent string according to claim 2 in which the layer of Vabsorbent material `comprises a cloth COVGI.
4. A blood-absorbent string according to claim 2 in which the layer of absorbent material is attached to at least one side of said tube.
5. In a blood-absorbent string `taken orally for locating bleeding in the gastro-intestinal tract, as described, and provided with radio-opaque markers along the length thereof, the improvement comprising:
a continuous, radio-transparent, elongated, collapsible thin wall tube, said 'tube being articulated so as to provide wide and narrow portions, when in inflated condition, and serving as the core for the string, and
having an open end and a swallowable end, and
a cover of absorbent, radio-transparent material attached to ythe outside of said tube and serving as an expansion-limiting means for said tube.
References Cited by the Examiner UNITED STATES PATENTS 3,060,972 10/1962 Sheldon 12S-2 X 3,097,636 7/1963 Haynes et al 12S-2 3,125,096 3/1964 Antiles et al. 128-401 3,155,091 11/1964 Nissenbaum et al. 128--2 3,217,705 11/1965 Billings 128-2 RICHARD A. GAUDET, Primary Examiner.
SIMON BRODER, Examiner.