Differentiate bougie dilation from balloon dilation for esophageal strictures.

• A. Bougie dilation uses sequential flexible dilators advanced over a guidewire.
• B. Bougie dilation uses a deflated balloon placed at the stricture and inflated to widen.
• C. Balloon dilation uses sequential dilators over a guidewire.
• D. Balloon dilation requires surgical access.

Answer: (A)

Bougie dilation relies on a series of progressively larger dilators, called bougies, that are passed over a guidewire and advanced one after another to widen the narrowed esophagus. This stepwise, mechanical widening is the hallmark of bougie dilation. In contrast, balloon dilation uses a single deflated balloon catheter placed at the stricture and then inflated to push the tissue outward, so the defining feature is the inflation of a balloon rather than sequential dilators. Endoscopically and with or without a guidewire, both approaches are common, but surgical access is not required for either method. Therefore, the description that bougie dilation uses sequential flexible dilators advanced over a guidewire best captures the method.