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esophageal dilation; bougienage
Indications:
- esophageal stricture due to: achalasia
Procedure:
1) wire-guided polyvinyl bougies -
a) Savary-Gilliard dilators
- relatively stiff & better suited to longer, tighter, & irregular strictures
- need for fluoroscopy is variable
- range is 5-20 mm; dilators are reusable
b) American dilators
- shorter, less tapered, & impregnated with barium for better fluoroscopic visualization
c) complications:
- trauma to the laryngeal wall
- patient discomfort
2) endoscopic balloon dilators
a) used through the endoscope
b) allow for direct visualization
c) relatively expensive, not reusable
d) fluoroscopy not mandatory, but useful in difficult cases
Specific
esophageal balloon distension
General
esophageal procedure
References
- Vasudeva R
Esophageal Stricture: Treatment & Medication
eMedicine
http://emedicine.medscape.com/article/175098-treatment