Bougienage
A bougienage or dilatation is the expansion of a constriction in a tubular organ of the body.
Bougienage of the esophagus (gullet)
Indications
- stenosing esophageal carcinoma
- congenital esophageal malformation
- High grade burns of the esophagus
- otherwise caused narrowing of the esophagus with difficulty swallowing
Methods
Bougienage is always carried out under sedation and analgesia , as otherwise it would be very painful for the patient. First a device is inserted with which one can view the esophagus from the inside (esophagoscope). A guide wire is then pushed over the constriction under visual inspection. There are basically two options for stretching:
- Bougie with a bougie: The bougie is a soft catheter without a cavity. The guide wire is mandatory for this type of expansion, otherwise there is a risk of perforation.
- Balloon dilation : In this method, a non-inflated balloon is inserted into the constriction so that the constriction can be expanded by inflating the balloon. The balloon is not filled with gas, as the term “inflation” suggests, but with a liquid. Gases are compressible and it would be much more difficult to use them to build up the pressure needed for dilation.
Aftercare
Sometimes a metal stent is inserted to keep the passage open to prevent further narrowing. After inserting a stent, the following rules of conduct are recommended:
- low-fiber food (no salad, high-fiber meat such as chicken etc.)
- chew every meal well
Bougienage of the gastric outlet
Indications
Narrowing of the stomach outlet caused by a tumor, inflammation, or congenital growth disorder
treatment
Essentially the same as treatment for esophageal tightness
Bougienage of the urethra
Indications
- Urethral stricture
- recurrent (recurring) urinary tract infections
method
In the urethra rods are inserted increasing thickness which remain in each case for several weeks in the urethra to dilate these slowly.
Bougienage of the (end) intestine
In special cases - for example a narrowing of the surgical site (anastomotic stenosis) after an intestinal tumor (e.g. rectal carcinoma) - a bougie with so-called Hegar pens is carried out.
Bougienage of the vagina / neovagina
After operations on the vagina or its regeneration during sex reassignment operations , a vaginal stent or a bougier stick is used to keep the vagina open.
Web links
- Treatment of stenoses through dilatation (Medical University of Marburg) ( Memento from January 4, 2008 in the Internet Archive )