Transgastric balloon-assisted hydrostatic dilation of the atretic esophagus

Esophageal atresia may be associated with a long interval or gap between the upper and lower pouches. Three infants with esophageal atresia and long gaps recently underwent hydrostatic dilation of the distal esophageal pouch, followed by primary anastomosis. The technique entailed passing a balloon-tipped catheter through a gastrostomy to the distal esophageal pouch. The balloon was inflated to a diameter sufficient to occlude the distal esophagus. Dilute contrast was then infused under fluoroscopic visualization to a maximal pressure of 145 cm of water. Dilations were carried out daily over a 2-week period, followed by surgery. Primary anastomosis was accomplished in all patients