Journal
RADIOLOGY
Volume 224, Issue 3, Pages 719-724Publisher
RADIOLOGICAL SOC NORTH AMERICA
DOI: 10.1148/radiol.2243011049
Keywords
achalasia; deglutition disorders; esophagus, interventional procedures; esophagus, stenosis or obstruction
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Purpose: To report our experience with balloon dilation for achalasia of the cardia. Materials and methods: Seventy-six patients (mean age, 51 years) underwent balloon dilation with radiologic guidance. A total of 110 procedures were performed from April 1994 to April 2000. Diagnosis of achalasia was established with clinical, radiologic, and manometric data. Dysphagia was a presenting symptom in most patients (90%), regurgitation was present in 39%, retrosternal pain in 22%, and weight loss in 12%. The dilations were performed in a progressive manner starting with a 15-mm-diameter balloon and progressing to 20-, 30-, and 40-mm balloons, as required. Follow-up data were collected retrospectively from patient notes and telephone interviews with the patients and/or their local doctors (mean follow-up, 26 months). Results: There were no cases of esophageal perforation; 89% (98 of 110) of dilations were considered to be successful, with the patients having restoration of normal or near-normal swallowing (excellent or good initial responses). Fifty-two patients required a single dilation; 22 patients, between two and four dilations; and two patients, five dilations. Conclusion: Balloon dilation with fluoroscopic guidance is a safe and successful treatment for achalasia of the cardia. (C) RSNA, 2002.
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