The Danger of High Compliance Balloons for Esophageal Dilatation in Achalasia

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Abstract
High compliance balloons, commonly used for pneumatic dilatation of achalasia patients, theoretically subject the widened esophageal wall, proximal to the narrow zone, to increased pressure, and subsequently to a higher risk of perforation. The new type of inelastic cylindrically shaped balloons, such as the Gruntzig-type and Rigiflex Achalasia Dilator, seems to be safer, since it increases esophageal wall tension in the stenotic zone only. The purpose of this study was to present a pathophysiological consideration of this assumption, together with two cases which support it.

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