Dilatation of severe esophageal strictures by an inflatable balloon catheter

Most benign strictures of the esophagus can be successfully dilated with conventional bougienage techniques. Occasionally strictures are so severe, lengthy, or irregular that these techniques fail, and surgery is required. We describe 2 patients with such severe esophageal strictures that conventional techniques were initially unsuccessful. However, esophageal dilatation of both strictures was successful using the Grüntzig balloon catheter. A torqueable guide wire was initially directed through the stricture under fluoroscopic control. The balloon catheter was then passed over the guide wire and inflated sequentially to a maximum diameter of 9 mm. Subsequent dilatations using conventional techniques were successful. The technique of negotiating severe, irregular esophageal strictures with a torqueable guide wire followed by Grüntzig balloon catheter dilatation may be valuable in the management of severe esophageal strictures.