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ESOPHAGEAL DILATION
SOME THINGS YOU SHOULD KNOW...
Dilation is a procedure used to stretch open a narrowed area in
the esophagus or other part of the gastrointestinal tract. Narrowing
or constriction of the esophagus usually causes difficulty swallowing.
Food or liquid may become lodged in the chest or neck. When this
occurs, it is a most distressing sensation and can cause pain
and a feeling of choking. Esophageal dilation usually will relieve
these symptoms if they are due to a narrowing. Dilation may also
relieve chest pain and swallowing difficulty in patients who suffer
from esophageal spasm.
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How is it performed?
Esophageal dilation is usually performed after examining the
esophagus with a gastroscope (see our pamphlet on gastroscopy).
Gastroscopy is necessary in order to clearly see what is causing
the problem and to exclude serious conditions such as cancer.
Most strictures are treated with Maloney dilators. These are tapered
rubber tubes which are passed gently down the throat and through
the stricture. A series of dilators of gradually larger sizes
are passed in order to enlarge the narrowed area. In some cases,
Maloney dilators cannot be used to safely dilate a stricture.
For these patients we use other techniques.
Balloon dilation.
Balloon dilators are long, sausage shaped balloons which are
passed through the scope and then inflated under pressure within
the stricture. This process is similar to what is done with coronary
angioplasty wherein small balloons are used to stretch open narrowed
areas in the coronary arteries.
Wire guided dilators (Savary dilators)
These dilators are tapered and shaped like Maloney dilators.
The scope is used to pass a guide-wire through the stricture.
The scope is then removed and the Savary dilators are passed over
the guide-wire through the stricture. The dilators have a small
passageway through the center which allows them to slide over
the wire. These are used when strictures are too firm or too narrow
to be dilated with Maloney dilators.
Fluoroscopy
X-ray guidance may be used with any of these dilating techniques
if the physician feels it is necessary.
Risks
Esophageal dilation carries a small but significant risk of
the following complications:
Reaction to Medication
Medication given for sedation can cause slowing of the breathing
and lowering of oxygen levels. We monitor oxygen levels continuously
in order to identify and treat this problem immediately if it
should occur. Monitoring is also performed in order to identify
any drops in blood pressure or changes in the pulse or heart rhythm.
Bleeding
Bleeding may occur during or after the dilation. If you experience
vomiting of blood or passage of black stool or become weak, dizzy
and pale, please notify our office immediately or go
directly to the emergency room.
Esophageal Perforation
This is the most serious complication of esophageal dilation.
It often requires major surgery for correction. Fortunately, it
is quite uncommon. Symptoms suggesting esophageal perforation
would include severe chest pain, abdominal pain, fever or shortness
of breath after dilation. If the physician suspects the possibility
of an esophageal perforation, then x-rays will be obtained to
identify this complication.
Sore Throat
About ten percent of patients undergoing endoscopy and/or
dilation may experience some mild sore throat. If this occurs,
Chloraseptic spray can be used to relieve the discomfort. This
generally resolves in a matter of a day or two. Please notify
our office if you are having any severe pain or swelling in the
neck. |
Updated 2/20/2001
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