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Balloon Dilatation
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Balloon dilatation is one of
several methods available to the Gastroenterologist for the
treatment of strictures of the gastrointestinal tract.
Strictures occur most commonly in the esophagus, but may also
occur in the pylorus, biliary tract and colon.
Prior to the widespread acceptance
of dilatation, most strictures had to be treated surgically. The
first advance in dilatation come about with the development of
the mercury-weighted bougie. The bougie is simply a stretching
device advanced down the esophagus (the only part of the GI
tract in which bougies can be used) until the stricture is
opened. This type of device, while still used, is considered
somewhat barbaric because of the patient discomfort it causes.
The second advance in dilatation
came with the development of over-the-wire Savarytype dilator.
While offering somewhat better control than the bougie, the
principal employed is the same. Not surprisingly the degree of
patient discomfort is also the same.
Trans-endoscopic balloon dilatation represents
the most advanced method to treat strictures. A stricture
is first visualized endoscopically. Then, a balloon
dilatation catheter is advanced through the working channel of
the endoscope until it exits the tip in the vicinity of the
stricture.
The tip of the balloon dilator is
advanced through the stricture and the balloon positioned so
that it is centered in the stricture. The balloon is then
inflated with saline solution to reach an indicated pressure.
The balloon may be inflated and deflated several times to assure
effective dilatation. In some cases, progressive dilatation may
be employed. That is, successively larger balloons may be
inflated to achieve stricture dilatation.
Most dilation procedures are for
benign strictures of the esophagus which make swallowing
extremely difficult. The pylorus may also stricture making
emptying of the stomach difficult. Ducts of the biliary tree may
stricture as a result of scarring, inflammation or cancer. And,
the colon may stricture usually as a result of surgical
scarring.
*Disclaimer*
The content of this page is
intended for educational and informational purposes only. This
information is not for procedural application. Please consult
your physician or healthcare provider for professional
consultation in regards to these educational topics.
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