Radiographic evaluation of esophagus immediately after pneumatic dilatation for achalasia.

Abstract:

:Forty-one (98%) of 42 patients with achalasia of the esophagus had pneumatic dilatation performed successfully using the Brown-McHardy dilator. One to four dilatations (mean, 1.9) were done on each patient with inflation pressures of 8-15 psi (mean, 11.1 psi). Immediately after the procedure, all patients were examined radiographically by injection of contrast material into the lower esophagus through a nasoesophageal tube. Two immediate and two delayed perforations occurred. Six intramural hematomas were noted, five of which resolved spontaneously. The luminal diameter at the esophagogastric junction increased from a mean of 4.2 mm before dilatation to 7.5 mm following treatment. Four patients with previous Heller myotomy were dilated without complications. Perforation was more common in patients with a minimal change in the esophagogastric diameter. Thirty-five patients (85%) improved symptomatically within several days following pneumatic dilatation. Excluding patients with perforation, the postdilatation appearance of the lower esophagus poorly correlated with clinical response.

journal_name

Dig Dis Sci

authors

Ott DJ,Richter JE,Wu WC,Chen YM,Castell DO,Gelfand DW

doi

10.1007/BF01297184

subject

Has Abstract

pub_date

1987-09-01 00:00:00

pages

962-7

issue

9

eissn

0163-2116

issn

1573-2568

journal_volume

32

pub_type

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