TY - JOUR TI - Percutaneous endoscopic gastrostomy as a tool to assist pneumatic dilation in a difficult case of sigmoid esophagus AU - Michopoulos, S AU - Stamatis, G AU - Karagiannis, S AU - Dimopoulos, F and AU - Archavlis, E AU - Archimandritis, AJ JO - The American Journal of Gastroenterology PY - 2006 VL - 101 TODO - 4 SP - 902-905 PB - Nature Publishing Group SN - 0002-9270 TODO - 10.1111/j.1572-0241.2006.00386.x TODO - null TODO - We describe a case of a long-standing, untreated achalasia with a huge sigmoid esophagus in a 58-year-old Caucasian man who declined surgery. All means of classical endoscopic approach for pneumatic dilation, including the use of an overtube, were impossible because any attempt to propel the balloon dilator made the guide wire pull back out of the stomach because of the large loops and the tortuosity of the esophagus. For this reason, we used, for the first time, a combined approach of percutaneous gastrostomy and endoscopy in order to fix the guide wire at two points, achieving a pneumatic dilation in this way. A few months later, a significant improvement in the symptoms and nutritional status of the patient were observed. ER -