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Radiology, Vol 209, 741-746, Copyright © 1998 by Radiological Society of North America
ARTICLES |
SG Kang, HY Song, MK Lim, HK Yoon, DE Goo and KB Sung
Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
PURPOSE: To review the prevalence and clinical importance of esophageal rupture during balloon dilation for treatment of esophageal stricture. MATERIALS AND METHODS: Fluoroscopically guided esophageal balloon dilation was performed within 9 years in 96 consecutive patients with esophageal strictures. Esophageal rupture was classified into three types: type 1 was intramural; type 2, transmural; and type 3, transmural with mediastinal leakage. RESULTS: Each patient underwent one to seven procedures, for a total of 191 procedures. Esophageal rupture occurred in 20 patients (21%). Type 1 esophageal rupture occurred in eight patients, type 2 in 11, and type 3 in one. All esophageal ruptures were detected immediately after the procedure. Sixteen patients were treated with fasting, parenteral alimentation, and antibiotics; two were treated surgically; and two were treated with stent placement. No treatment-related deaths occurred. CONCLUSION: The overall prevalence of esophageal rupture was 21%. A substantial number of patients who developed type 1 rupture had associated clinical symptoms, such as pain and fever, but responded to conservative management and are thus included as having complications of esophageal balloon dilation.
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