Pneumatic dilatation of the achalasic esophagus requiring the aid of an endoscope.
We describe a 65-yr-old man with achalasia, who had two previous Heller myotomies. He had a markedly dilated, tortuous esophagus, which defeated initial attempts at pneumatic dilatation. A method was improvised in which a Brown-McHardy dilator was attached by a string to a small caliber endoscope and both were successfully passed into the stomach. Pneumatic dilatation was then easily performed. Review of the literature and our experience with four patients suggests that pneumatic dilatation can be performed without substantial risk in patients after a failed Heller myotomy.
D000368:Aged; D004106:Dilatation / Q000379:methods*; D004931:Esophageal Achalasia / Q000628:therapy*; D004945:Esophagoscopy; D006801:Humans; D008297:Male