Multiple benign strictures of the oesophagus in the paediatric age-group--modified technique of antegrade dilatation.

Accidental ingestion of strong acids and alkalines still remains the commonest cause of benign strictures of the oesophagus in our country, particularly in children from the poor socio-economic strata, who are left alone to fend for themselves. Once the stricture is well-formed, repeated antegrade dilatations are required in order to dilate the lumen gradually. The procedure is done with the utmost care and gentleness in order to avoid rupture of the cicatricial wall of the oesophagus. The present series consisting of 10 cases of multiple, benign, mostly permeable, strictures of the oesophagus were successfully managed with Jackson's antegrade dilatation technique. During one of the dilatation sessions we observed that instead of pushing the bougie gently, it seemed to be sucked down entirely on its own, a few millimeters at a time (described in case 3) and traversed the entire stricture. This procedure appears safer for the patient and has now become routine with us. There was no mortality in our series. In all, a total of 168 dilatations have been done. The average lumen achieved in all our cases was 6 mm (Jackson's bougie No. 18) which was well maintained in all our cases on a permanent basis.