Endoscopy 2019; 51(04): S171
DOI: 10.1055/s-0039-1681675
ESGE Days 2019 ePoster podium presentations
Saturday, April 6, 2019 10:30 – 11:00: Esophagus stenosis ePoster Podium 4
Georg Thieme Verlag KG Stuttgart · New York

BOUGIE CAP IN THE TREATMENT OF ESOPHAGEAL PEPTIC STRICTURE

J Cortez Pinto
1   Gastroenterology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
,
S Mão de Ferro
1   Gastroenterology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
,
A Dias Pereira
1   Gastroenterology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 

Introduction and aims:

Various methods are available for endoscopic treatment of benign stenosis in the upper gastrointestinal tract. The most common is the sequential use the of Savary-Gillard bougies after passing a guide-wire through the stenosis. The main problem of this method is the lack of direct visual control of the bougienage procedure. The Bougie caps are single use caps of different sizes that can be attached to an endoscope. The bougienage is carried out by advancing the endoscope through the stenosis while allowing good visualization of the surrounding tissue.

Our aim was to present our first experience of stricture dilation with the Bougie cap. We selected a 58-year-old male with a peptic stricture, already submitted to multiple dilations, with persistent dysphagia.

Methods:

Our patient presented an esophageal stenosis with an estimated luminal diameter of 4 mm that could not be passed with a 5,4 mm gastroscope. The 8 mm Bougie Cap was attached to the 5,4 mm gastroscope tip and placed proximally to the stricture. A nitinol guidewire was advanced through the cap surpassing the stricture. The bougienage was accomplished by advancing the scope trough the stenosis using gentle rotations movements.

The procedure was sequentially repeated with a 10 mm Bougie cap (5,4 mm gastroscope) and with a 12 mm Bougie cap (9,2 mm gastroscope).

Inspection without Bougie Cap was done in the end of the procedure. The procedure completion with a 14 mm and 16 mm Bougie cap was scheduled 3 weeks later but a 5 mm stricture was recognized and the previous sequence was made (8, 10 and 12 mm Bougie caps).

Results:

There were no immediate or delayed complications in both procedures. Procedure time was 31 minutes in the first exam and 16 minutes in the last.

Conclusions:

Bougie cap is a safe and easy new therapeutic method for oesophageal benign strictures under direct visualization.