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Endoscopic balloon dilation in caustic-induced chronic gastric outlet obstruction.
Gastrointest Endosc 2009; 69(4):800-5GE

Abstract

BACKGROUND

The standard treatment of caustic-induced gastric outlet obstruction (GOO) is surgery. There are only a few reports in the medical literature on endoscopic balloon dilation (EBD) for caustic-induced GOO.

OBJECTIVE

To study the short-term and long-term response of EBD in patients with caustic-induced GOO.

SETTING

Tertiary-care center in India.

DESIGN

Retrospective analysis of data.

PATIENTS

Of the 49 patients with caustic-induced GOO seen by us between January 1998 and December 2003, 41 were treated by EBD. Thirty-seven patients had consumed an acid and 4 had consumed an alkali a mean (SD) of 19.5 +/- 14.5 weeks earlier. EBD was performed every 3 weeks by using through-the-scope balloons under endoscopic guidance.

INTERVENTION

The balloon was negotiated across the narrowed segment and inflated for 60 seconds by using a pressure gun. Balloons of incremental diameters, up to a maximum of 3 sizes, were used in each sitting. The end point of dilation was 15 mm, after which patients were assessed for recurrence. The patients were observed until August 2007.

RESULTS

All 41 patients (23 men; mean [SD] age 29.6 +/- 8.5 years) could be successfully taken for EBD. Thirty-nine patients underwent successful repeated dilations, which required a mean (SD) of 5.8 +/- 2.6 dilations (range 2-13) to achieve the end point of 15 mm. All 39 patients were followed up for an average (SD) of 35.4 +/- 11.1 months (range 18-58 months). The mean (SD) size of the first dilator was 8.2 +/- 0.6 mm (range 8-10 mm). One patient had a perforation and was subjected to antrectomy; another patient had pain every time he received EBD; he also had surgery. Other complications were minor: self-limiting pain (n = 8) or bleeding (n = 7).

CONCLUSIONS

EBD is a safe, effective, and long-lasting alternative to surgery for caustic-induced GOO.

Authors+Show Affiliations

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. dr_kochhar@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19136104

Citation

Kochhar, Rakesh, et al. "Endoscopic Balloon Dilation in Caustic-induced Chronic Gastric Outlet Obstruction." Gastrointestinal Endoscopy, vol. 69, no. 4, 2009, pp. 800-5.
Kochhar R, Dutta U, Sethy PK, et al. Endoscopic balloon dilation in caustic-induced chronic gastric outlet obstruction. Gastrointest Endosc. 2009;69(4):800-5.
Kochhar, R., Dutta, U., Sethy, P. K., Singh, G., Sinha, S. K., Nagi, B., ... Singh, K. (2009). Endoscopic balloon dilation in caustic-induced chronic gastric outlet obstruction. Gastrointestinal Endoscopy, 69(4), pp. 800-5. doi:10.1016/j.gie.2008.05.056.
Kochhar R, et al. Endoscopic Balloon Dilation in Caustic-induced Chronic Gastric Outlet Obstruction. Gastrointest Endosc. 2009;69(4):800-5. PubMed PMID: 19136104.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic balloon dilation in caustic-induced chronic gastric outlet obstruction. AU - Kochhar,Rakesh, AU - Dutta,Usha, AU - Sethy,Pradeepta K, AU - Singh,Gursewak, AU - Sinha,Saroj Kant, AU - Nagi,Birinder, AU - Wig,Jai Dev, AU - Singh,Kartar, Y1 - 2009/01/10/ PY - 2008/02/09/received PY - 2008/05/18/accepted PY - 2009/1/13/entrez PY - 2009/1/13/pubmed PY - 2009/7/16/medline SP - 800 EP - 5 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 69 IS - 4 N2 - BACKGROUND: The standard treatment of caustic-induced gastric outlet obstruction (GOO) is surgery. There are only a few reports in the medical literature on endoscopic balloon dilation (EBD) for caustic-induced GOO. OBJECTIVE: To study the short-term and long-term response of EBD in patients with caustic-induced GOO. SETTING: Tertiary-care center in India. DESIGN: Retrospective analysis of data. PATIENTS: Of the 49 patients with caustic-induced GOO seen by us between January 1998 and December 2003, 41 were treated by EBD. Thirty-seven patients had consumed an acid and 4 had consumed an alkali a mean (SD) of 19.5 +/- 14.5 weeks earlier. EBD was performed every 3 weeks by using through-the-scope balloons under endoscopic guidance. INTERVENTION: The balloon was negotiated across the narrowed segment and inflated for 60 seconds by using a pressure gun. Balloons of incremental diameters, up to a maximum of 3 sizes, were used in each sitting. The end point of dilation was 15 mm, after which patients were assessed for recurrence. The patients were observed until August 2007. RESULTS: All 41 patients (23 men; mean [SD] age 29.6 +/- 8.5 years) could be successfully taken for EBD. Thirty-nine patients underwent successful repeated dilations, which required a mean (SD) of 5.8 +/- 2.6 dilations (range 2-13) to achieve the end point of 15 mm. All 39 patients were followed up for an average (SD) of 35.4 +/- 11.1 months (range 18-58 months). The mean (SD) size of the first dilator was 8.2 +/- 0.6 mm (range 8-10 mm). One patient had a perforation and was subjected to antrectomy; another patient had pain every time he received EBD; he also had surgery. Other complications were minor: self-limiting pain (n = 8) or bleeding (n = 7). CONCLUSIONS: EBD is a safe, effective, and long-lasting alternative to surgery for caustic-induced GOO. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/19136104/Endoscopic_balloon_dilation_in_caustic_induced_chronic_gastric_outlet_obstruction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(08)01989-5 DB - PRIME DP - Unbound Medicine ER -