Pneumatic Dilatation of Achalasia

  • – Distension of LES to 3 cm
  • – Partial disruption of LES circular muscle
  • – Balloon dilation period ranges from several seconds to 5 minutes
  • – If unsatisfactory : Repeat the procedure with larger diameter balloon within week
  • – Clinical efficacy of dilation 32-98%
  • – Patients having poor initial result or rapid recurrence of symptoms: diminished likelihood of responding to additional dilation
  • – Complications of pneumatic dilation

                              Esophageal perforation

  • – Perforation easily evident within an hour of procedure
  • – Patient should be closely observed for at least 2 hour to detect esophageal leak
  • – Symptoms of perforation
  •                • Persistent chest pain
  •                • Fever

Treatment of perforation

  • Minor perforation
  •  – Conservative treatment by NPO + I.V antibiotic
  • Major perforation
  • – Surgery

 


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