Dilation (UES, esophagus, LES) balloon dilations, bougies

Abstract

Benign esophageal strictures result from a variety of injuries causing local or diffuse narrowing of the lumen and compromising swallowing. Subsequently, nutritional health becomes impaired necessitating mechanical treatment (dilation) of the stricture. Esophageal strictures are defined as simple or complex depending upon their structure and extent. The type and use of esophageal dilators often depends upon the nature of the stricture and the associated clinical situation. Some esophageal strictures respond predictably to dilations; others are more formidable or refractive to serial stretching. This chapter details the appropriate use and technique of using the balloon or Bouginage dilating instruments. Stratification of the patient population __clinical evaluation the risks and benefits of esophageal dilations and associated complications are detailed. Potential new treatment with esophageal stenting is also discussed in light of recent early experience. Appropriate endoscopic photographs are included to augment the teaching points.