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Gastrointest Endosc. 2010 Apr;71(4):737-44. doi: 10.1016/j.gie.2009.11.038.

Early endoscopic balloon dilation in caustic-induced gastric injury.

Author information

1
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. dr_kochhar@hotmail.com

Abstract

BACKGROUND:

There are no reports on endoscopic balloon dilation (EBD) for caustic-induced gastric outlet obstruction (GOO) in the acute or subacute phase.

OBJECTIVE:

To study the efficacy of early EBD in patients with caustic-induced gastric injury.

SETTING:

Tertiary care center in India.

DESIGN:

Retrospective analysis of data.

PATIENTS:

Out of 41 patients with caustic-induced GOO who reported to us in the subacute phase between January 2001 and December 2008, 31 were treated by EBD. All 31 had ingested an acid 14.39 +/- 4.65 days earlier. EBD was achieved by using wire-guided balloons under endoscopic guidance.

INTERVENTION:

The balloon was negotiated across the narrowed segment and inflated for 60 seconds using a pressure gun. Balloons of incremental diameter, up to a maximum of 3 sizes, were used in each sitting. Procedural success was defined as reaching the end point of dilation (15 mm) and absence of symptoms.

RESULTS:

All 31 patients (18 male, mean age 32.06 +/- 11.04 years) could be successfully dilated. All but 1 underwent successful dilations to achieve the end point of 15 mm, requiring a median of 9 (range 3-18) dilations over a period of 7 (range 1.5-16) weeks. Complications included self-limiting pain (n = 10), bleeding at the time of the procedure (n = 9), and perforation in 1 patient (3.2%) who required surgery. Thirty patients were followed up for a median of 21 (range 3-72) months with no recurrence.

CONCLUSION:

Early EBD by an expert endoscopist is a safe and effective treatment modality in the management of caustic-induced GOO.

PMID:
20363415
DOI:
10.1016/j.gie.2009.11.038
[Indexed for MEDLINE]
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