Another difficult case

We had a 42-year-old male who had an unexplained stricture of the proximal esophagus, Prior attempts at getting through the stricture had failed, a PEG tube had been placed surgically. Prior biopsies of the area were negative. All that we had was a small 30 mm dilating balloon. No dilating balloon gun was available, so this had to be done with physical pressure by the physician while another physician used the EGD scope to ensure proper placement, Thereafter, dilation was successful with direct visualization with a scope since there was no radiology availability.