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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).

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.

© RSNA, 2002

Index terms: Achalasia, 715.745 • Deglutition disorders • Esophagus, interventional procedures, 71.12168, 71.1232 • Esophagus, stenosis or obstruction, 71.744, 71.745

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				M. C. Uthappa, R. Uberoi, J. Phillip-Hughes, P. Boardman, T. Sabharwal, M. Cowling, J. Dussek, W. Owen, and A. Adam Balloon Dilation for Achalasia of the Cardia: A Day Case Procedure [letter] * Dr Sabharwal and colleagues respond: Radiology, August 1, 2003; 228(2): 594 - 594. [Full Text] [PDF]