Abstract
In nine of ten patients with achalasia, passive dilation with Maloney mercury-filled esophageal bougies 50 to 60 French has resulted in satisfactory management of dysphagia over the period of 6 months to 2 years (mean 18 months) of follow-up. Three patients had excellent symptomatic result with a single dilation session with 60 French in two patients and 50 French in one patient. It is noteworthy that a 36 y. o. female who was unable to eat and cahectic was successfully treated by two sessions with 60 French bougie and she has been totally asymptomatic over 6 months with weight gains of 18 kg to the usual body weight before the onset of her disease. The result of the remaining five patients were good, in whom repeat dilations (2 to 6 times) have been needed over the period of 1.4 to 2.6 years of follow-up. In a case of vigorous achalasia, bougienage induced severe substernal pain attack and failed in relief of his dysphagia. Although the role of passive bougienage in achalasia has been deprecated, our experience indicates that bougienage with 60 French is useful with ease and safety, and the relief produced is not transient.
