Intraluminal pressures generated during esophageal bougienage

Although esophageal bougienage is a widely used palliative procedure for both benign and malignant esophageal strictures, little is known about the pressure generated or applied to the esophageal wall during this procedure. Accordingly, water-perfused catheters were radially implanted into Maloney dilators to monitor esophageal wall pressure in 13 patients undergoing bougienage for reflux-induced lower esophageal strictures. Maximal pressure generated in this group ranged from a low of 25 to a high of 830 mmHg and was generally higher in individuals with newly dilated strictures and with use of larger bougies. In a control group of 11 patients, resting esophageal wall pressure during dilation was 5 mmHg, a value similar to that measured in stricture patients. Maximal pressure occurred in the area of the lower esophageal sphincter and was not statistically higher than sphincter pressure measured with standard rapid pull-through technique. These studies help to define esophageal wall response to bougienage and the pressures generated at the time of esophageal dilation.