Abstract
From 1974 to 1979, 7 patients with achalasia of the esophagus have been treated solely by the technique of pneumatic dilatation using a pneumatic dilator. The pneumatic bag was inflated under fluoroscopic control to 80mmHg at the first day, then to 160mmHg and, finally to a pressure of 260mmHg repeatedly every other day for at least 2 weeks. Evaluation for the treatment was based synthetically on symptoms, a radiological examination, an endoscopic examination and esophageal manometric studies. Following these evaluations, we obtained good results in all patients. The effects were classified as excellent in 4 of the 7 patients and good in 3. (Table 3) (Figure 8-13) The best result was obtained in a patient with a history of 50 years, and in this case the pneumatic bag was covered with streaks of bright red blood after forced dilatation of the cardia though the pneumatic dilator. (Figure 10) A case of the slightly sigmoid-shaped type in which the pneumatic bag could not be introduced accurately at the beginning of treatment, obtained a good result with this technique. It is concluded that forceful dilatation using a pneumatic dilator should be first attemped for the treatment of achalasia.
