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Image guided esophageal dilation procedure

Esophageal dilation

An image guided esophageal dilation procedure is a procedure performed to help increase the size of the opening in your child’s esophagus.  The esophagus is the tube that carries food or liquids from the mouth to the stomach.  The narrowing can prevent food or drink from passing into the stomach and back up into the mouth.  It can also cause your child to have excessive drooling of saliva as this also can have difficulty passing through the narrowed esophagus.  As a result, your child may not be able to receive adequate nutrition or become at risk for aspiration (contents going down the airway) and lung infections.

Conditions treated by this procedure

The most frequent cause of esophageal stricture (narrowing) in children are a result of complications related to prior surgeries involving the esophagus such as children who have a history of esophageal atresia or trachea-esophageal fistula (conditions in which children are born with an abnormal closure or communication of the esophagus to the airway).  Other conditions in children that may lead to esophageal stricture include ingestion of toxic material or prior radiation or injury to the esophagus area.

Treatment and recovery

The procedure typically requires 30 – 60 minutes to complete. During this time, your child will typically be sedated with anesthesia. A catheter is placed through the mouth into the stomach across the area where the esophagus is narrowed.  An balloon is positioned at the site of narrowing using X-ray guidance.  The balloon is inflated to stretch the narrowing and increase the size of the narrowing.  The balloon is deflated and x-ray dye is injected into the esophagus to ensure that the opening is sufficient.  The balloon and catheter are then removed.

Following the procedure, your child can generally sit in bed, a chair or walk following recovery from anesthesia sedation. Your child may be limited to liquids initially following the procedure then advanced as tolerated to other forms of nutrition. Your child may have some soreness following the procedure.  Typically this can be well controlled with ibuprofen or Tylenol.  Your child may also have some discomfort with swallowing following the procedure for the first 24 hours. Your child can resume normal activities as tolerated following the procedure.

Initially following the procedure and recovering from anesthesia your child will be limited to clear liquids to determine if your child can tolerate oral intake.  Your child may be limited to soft puree foods for the first 24 hours then transitioned to diet as tolerated there-after

Esophageal dilation risks

There is the potential risk that the dilation can cause a tear in the esophagus.  This is generally self limiting and will heal.  However, rarely this can lead to leakage of contents into the chest and potentially an infection.
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Center of Excellence

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Children's Hospital of Wisconsin's imaging department just received the Diagnostic Imaging Center of Excellence by the American College of Radiology. Our imaging department was the third children's hospital in the nation to receive this prestigious credential.