NEGOTIATING THE DIFFICULT ESOPHAGEAL STRICTURE

Very narrow oesophageal strictures, although visible on contrast exami nation, may not be amenable to safe prograde dilatation. A technique u sed in four recent cases where attempts at prograde dilatation had fai led is described. The strictures were easily negotiated from below via a gastrostomy and the distal oesophagus using an Arrow Duoflex guide wire for subsequent string-guided dilatation. Access to the lower oeso phagus was easily achieved using a Portex blue-line endotracheal tube. This method appears quick, safe, and reliable.