What is Bougienage?

A bougienage is a medical procedure in which a cylinder known as a bougie is inserted into an opening such as the esophagus. This procedure is used to treat a number of conditions, and also during diagnostic workups and evaluations. Physicians in a number of specialties may use this technique in their practices, with one common location for a bougienage being an emergency room, where a doctor may need to act quickly to do something like clearing a blockage.

Bougies are tubes made from materials such as rubber, plastics, or metal. Some are plain cylinders, while others may be equipped with fittings such as lights, inflatable balloons, or guide wires. The doctor selects a bougie of an appropriate size for the job, and guides it carefully into a structure such as the urethra, intestines, anus, or esophagus. The bougienage may be done with the assistance of fluoroscopy, to ensure that the bougie is properly placed.

One reason to perform a bougienage is to widen an opening which has become constricted. In this case, the bougie may be fitted with an inflatable balloon which can be used to force expansion. This technique can also be used to clear a blockage, by widening a passage to allow the offending blockage to pass through. When clearing a blockage, care must be taken to confirm that it will not damage structures below the level of the blockage. For example, if something drops from the esophagus into the stomach, it is important that it not be capable of damaging the intestines on its way out the body.

Another reason to perform a bougienage is for the purpose of introducing medical instruments, or for getting a closer look at a structure inside the body, with the assistance of the light and a camera. Doctors can also introduce tracer materials and medications via a bougie. In progressive dilation procedures, bougies of increasingly larger sizes are inserted, with the assistance of lubricants to reduce the risk of injury.

There are some risks to a bougienage, as there are with many medical procedures. If a tube of the wrong size or length is used, or not sufficiently lubricated, it could cause internal injuries to the patient. Performed without guidance such as fluoroscopy, a bougienage could also result in misplacement of the tube, which could cause complications. In the case of dilation procedures, it is possible to cause rupture or other damages, and when clearing blockages, bougienage can also be risky for the patient. Patients should ask their physicians to discuss the risks of the procedure before they begin.