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Coming to the complications of oesophageal dilatation, like any procedure which is forceful in the body, it can lead to complications like local injury wherein there is an injury to the local structures like wall of the food pipe, or it can lead to bleeding because of the tear. You are forcefully opening it, so the walls can tear and it can lead to small infections or the tear itself can lead to scars. In the later stages can lead to the recurrence of the disease. Again the narrowing of the food pipe can happen if it is done very forcefully. That is why it is preferably done in a stage wise manner, you do it progressively. Start with the smallest possible bougie and go up in size till it is comfortable for the person to swallow, which is about 1 cm size of bougie which is commonly used. The other important complication that can happen is when we force dilate the lumen, we can accidentally tear the wall in such a way that there is a false passage that is created. Instead of the bougie going into the oesophageal lumen, it gets into the false passage which goes into the thorax, the chest and then it can damage structures there including the major blood vessels like aorta or the pericardium or even the lungs can be punctured and then it leads to lot of complications and of course a person swallows 4 – 5 times a minute. SO even his swallow, the saliva can get into the tear and get into the chest by that and cause a lot of infections. Saliva contains obviously normal bacteria commensals and all other material which can get into the chest and you know lead to lot of infections locally and cause a lot of major issues in the chest. The other complications can be failure of dilatation. If the stricture is to tight or if the stricture is too long, the dilatation may not be successful in relieving the obstruction and thus there is a failure of the dilatation. The other complication could be recurrence. Most of the time scarring tends to happen over and over again because forceful dilatation leads to injury and then scar forms again and thus the recurrence can happen as a complication.