Transgastric esophagoscopy with antegrade dilation.

An 80-year-old man in whom successful dilation of an obstructed esophagus via retrograde esophagoscopy was carried out is reported here. His nutrition had been previously sustained by a feeding gastrostomy tube inserted under radiologic guidance. This gastrostomy stoma was dilated to allow passage of a pediatric gastroscope into the stomach and esophagus. A guide wire was then negotiated past the esophageal stricture, under endoscopic vision and fluoroscopic guidance, into the oropharynx. Savary dilators were then passed over the guide wire perorally to dilate the stenosis. The patient was able to swallow liquids soon after the procedure. The use of Savary dilators over a guide wire introduced by retrograde esophagoscopy has not been previously described.