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Balloon Dilation for Achalasia of the Cardia: Experience in 76 Patients¹

¹ From the Departments of Interventional Radiology (T.S., M.C., A.A.) and Surgery (J.D., W.O.), Guy’s and St Thomas’ Hospital, Lambeth Palace Rd, SE1 7EH London, England. Received June 14, 2001; revision requested July 9; final revision received January 22, 2002; accepted February 1. Address correspondence to T.S. (e-mail: tarun_sabharwal@yahoo.co.uk).

View larger version (74K): [in a new window]   Figure a. Erect fluoroscopic images in a 42-year-old man with achalasia. (a) Image shows contrast material in the esophagus, which has a smooth tapered beaklike appearance (arrow) at the level of the esophageal hiatus. (b) Partially inflated balloon shows formation of a waist (arrow) at the diaphragmatic waist. (c) Additional inflation of the balloon shows complete obliteration of the waist (arrow). (d) Image shows successful dilation of lower esophageal segment and no evidence of leak after administration of a barium agent.

View larger version (86K): [in a new window]   Figure b. Erect fluoroscopic images in a 42-year-old man with achalasia. (a) Image shows contrast material in the esophagus, which has a smooth tapered beaklike appearance (arrow) at the level of the esophageal hiatus. (b) Partially inflated balloon shows formation of a waist (arrow) at the diaphragmatic waist. (c) Additional inflation of the balloon shows complete obliteration of the waist (arrow). (d) Image shows successful dilation of lower esophageal segment and no evidence of leak after administration of a barium agent.

View larger version (106K): [in a new window]   Figure c. Erect fluoroscopic images in a 42-year-old man with achalasia. (a) Image shows contrast material in the esophagus, which has a smooth tapered beaklike appearance (arrow) at the level of the esophageal hiatus. (b) Partially inflated balloon shows formation of a waist (arrow) at the diaphragmatic waist. (c) Additional inflation of the balloon shows complete obliteration of the waist (arrow). (d) Image shows successful dilation of lower esophageal segment and no evidence of leak after administration of a barium agent.

View larger version (104K): [in a new window]   Figure d. Erect fluoroscopic images in a 42-year-old man with achalasia. (a) Image shows contrast material in the esophagus, which has a smooth tapered beaklike appearance (arrow) at the level of the esophageal hiatus. (b) Partially inflated balloon shows formation of a waist (arrow) at the diaphragmatic waist. (c) Additional inflation of the balloon shows complete obliteration of the waist (arrow). (d) Image shows successful dilation of lower esophageal segment and no evidence of leak after administration of a barium agent.