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Esophageal Dilatation

What is esophageal dilatation?

The esophagus, which is the tube that carries food from the mouth to the stomach, can become narrowed and cause swallowing difficulty. Causes of this narrowing include stricture formation, usually after surgery, allergies, or even injury from caustic substances. Dilatation is when a high-pressure balloon is inserted into the esophagus and inflated to open up these narrowed portions.

About this Treatment Pre and Post Operative Care Departments

About this Treatment

How do we perform an esophageal dilatation?

A radiologist will use live x-ray images to guide a flexible wire down the mouth and esophagus to a point just past the narrowed portion. A deflated high-pressure balloon, attached to a catheter, is guided down to the narrowed portion over the guide wire and is inflated until visible opening and stretching of the esophagus is documented. If decided by the physician during the procedure, an additional, larger balloon may be used as well.

Will my child feel any pain?

Your child will not feel pain during the procedure but it is not uncommon for children to experience pain with swallowing in the first 24 hours after the procedure. This is easily treatable with over-the-counter medications.

Will my child be awake for the procedure?

This procedure requires your child to be asleep for which we will administer intravenous sedation or general anesthesia.

What are the risks of esophageal dilatation?

The procedure is considered low-risk. However, potential complications include:

Esophageal tear
Bleeding at the treatment site (coughing or throwing up blood)
Mediastinitis (severe inflammation of tissue in the chest area)

Pre and Post Operative Care

How do my child and I prepare for the procedure?

We encourage good communication between you and your child about the procedure, the reason for it and ensuring them that you will be close by the entire time. Holding them or their hands until they leave for the procedure is a great way to provide support.

You will be given specific instructions along the way but you may need to arrive a few hours before the scheduled procedure to have some blood tests done. When you arrive at the hospital, a doctor will review the procedure and associated risks, after which you will sign a consent form. When we are ready to get started with the procedure, a nurse will place an intravenous line to deliver sedating medications and you will be allowed to accompany your child in the operating room until they are asleep, after which you will be escorted to a waiting room.

What should we expect after the procedure?

Nurses will monitor your child in the recovery area for 4-6 hours for successful recovery from anesthesia and any immediate complications. The physician may decide to admit your child to the hospital overnight for observation. Food and drinking will not be allowed for a few hours after the procedure, after which liquids will be given to your child to see if they are tolerated. If tolerated, a soft non-hot food diet will be prescribed for 24 hours, during which time no “sharp” food such as cookies, chips, and crackers are allowed. A regular diet may be resumed after these 24 hours.

When can my child resume normal activity?

We recommend complete bed rest for the remainder of the day after the procedure. The next day, your child may resume normal light activities like normal school-going or daycare attendance but must refrain from intense physical activity like contact sports and rough playing for one week.

CONTACT CNMC IMMEDIATELY IF YOUR CHILD EXPERIENCES ANY OF THE FOLLOWING:

• Intense pain on swallowing.

• Any visible swelling or bruising.

• Fever higher than 101^o Fahrenheit or 38^o Celsius.

The department of Interventional Radiology can be reached at: 202-476-3791, Monday through Friday, between 8 a.m. and 5 p.m.

At all other times please call 202-259-8643, which is the on-call pager. Follow the instructions and wait for a call back.

Departments

Interventional Radiology

Children’s National interventional radiologists perform a full range of minimally invasive, image-guided procedures to both diagnose and treat disease in infants, children, and adolescents.

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