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Management of transmesenteric tunnel jejunal strictures with endoscopic dilation by using achalasia balloons (with videos).
Gastrointest Endosc. 2009 Jul; 70(1):154-8.GE

Abstract

BACKGROUND

Roux-en-Y gastric bypass is the most commonly performed bariatric operation in the United States. Transmesenteric tunnel (TMT) or mesocolic jejunal stricture is an unusual postoperative complication that requires another operation. We hypothesize that endoscopic dilation by using achalasia dilatation balloons can be used to treat some TMT jejunal strictures.

PATIENTS

This study involved 6 consecutive cases of TMT stricture.

INTERVENTION

The TMT strictures were dilated by using achalasia balloons (30-40 mm) under fluoroscopic and endoscopic guidance.

RESULTS

With endotherapy, 4 patients with late onset of symptoms (>3 weeks after Roux-en-Y gastric bypass) have not required another operation to date, with a follow-up of at least 5 to 12 months. Two patients with early onset of symptoms (<3 weeks after surgery) required operations, and 1 of these patients (symptoms onset <7 days after surgery) developed jejunal perforation within the stricture during dilation due to underlying jejunal ischemia within the stricture.

LIMITATIONS

Small case number and limited follow-up period.

CONCLUSION

Endoscopic dilation by using achalasia balloons can be used to treat some TMT jejunal strictures without another operation. Surgery should be considered in patients with early onset of obstructive symptoms and/or with jejunal ischemia within the stricture.

Authors+Show Affiliations

Department of Gastroenterology, Hepatology, and Endoscopy, Trinity Mother Frances Hospitals and Clinics, Tyler, Texas 75702, USA. sjtang2000@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19559837

Citation

Tang, Shou-jiang, et al. "Management of Transmesenteric Tunnel Jejunal Strictures With Endoscopic Dilation By Using Achalasia Balloons (with Videos)." Gastrointestinal Endoscopy, vol. 70, no. 1, 2009, pp. 154-8.
Tang SJ, Provost DA, Livingston E, et al. Management of transmesenteric tunnel jejunal strictures with endoscopic dilation by using achalasia balloons (with videos). Gastrointest Endosc. 2009;70(1):154-8.
Tang, S. J., Provost, D. A., Livingston, E., & Scott, D. J. (2009). Management of transmesenteric tunnel jejunal strictures with endoscopic dilation by using achalasia balloons (with videos). Gastrointestinal Endoscopy, 70(1), 154-8. https://doi.org/10.1016/j.gie.2009.02.011
Tang SJ, et al. Management of Transmesenteric Tunnel Jejunal Strictures With Endoscopic Dilation By Using Achalasia Balloons (with Videos). Gastrointest Endosc. 2009;70(1):154-8. PubMed PMID: 19559837.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of transmesenteric tunnel jejunal strictures with endoscopic dilation by using achalasia balloons (with videos). AU - Tang,Shou-jiang, AU - Provost,David A, AU - Livingston,Edward, AU - Scott,Daniel J, PY - 2008/11/11/received PY - 2009/02/11/accepted PY - 2009/6/30/entrez PY - 2009/6/30/pubmed PY - 2009/9/23/medline SP - 154 EP - 8 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 70 IS - 1 N2 - BACKGROUND: Roux-en-Y gastric bypass is the most commonly performed bariatric operation in the United States. Transmesenteric tunnel (TMT) or mesocolic jejunal stricture is an unusual postoperative complication that requires another operation. We hypothesize that endoscopic dilation by using achalasia dilatation balloons can be used to treat some TMT jejunal strictures. PATIENTS: This study involved 6 consecutive cases of TMT stricture. INTERVENTION: The TMT strictures were dilated by using achalasia balloons (30-40 mm) under fluoroscopic and endoscopic guidance. RESULTS: With endotherapy, 4 patients with late onset of symptoms (>3 weeks after Roux-en-Y gastric bypass) have not required another operation to date, with a follow-up of at least 5 to 12 months. Two patients with early onset of symptoms (<3 weeks after surgery) required operations, and 1 of these patients (symptoms onset <7 days after surgery) developed jejunal perforation within the stricture during dilation due to underlying jejunal ischemia within the stricture. LIMITATIONS: Small case number and limited follow-up period. CONCLUSION: Endoscopic dilation by using achalasia balloons can be used to treat some TMT jejunal strictures without another operation. Surgery should be considered in patients with early onset of obstructive symptoms and/or with jejunal ischemia within the stricture. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/19559837/Management_of_transmesenteric_tunnel_jejunal_strictures_with_endoscopic_dilation_by_using_achalasia_balloons__with_videos__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(09)00337-X DB - PRIME DP - Unbound Medicine ER -