Early endoscopic balloon dilation in caustic-induced gastric injury.

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.

• Authors: Rakesh Kochhar, Kuchhangi Sureshchandra Poornachandra, Usha Dutta, Amit Agrawal, Kartar Singh
• Journal: Gastrointestinal endoscopy (Gastrointest Endosc) Vol. 71 Issue 4 Pg. 737-44 (Apr 2010) ISSN: 1097-6779 [Electronic] United States
• PMID: 20363415 (Publication Type: Journal Article)
• Copyright: Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Chemical References

• Caustics

Topics

• Adult
• Burns, Chemical (complications, pathology, therapy)
• Catheterization (methods)
• Caustics (toxicity)
• Female
• Follow-Up Studies
• Gastric Outlet Obstruction (therapy)
• Gastroscopy (methods)
• Humans
• Male
• Pylorus (injuries, pathology)
• Stomach (injuries, pathology)
• Treatment Outcome
• Young Adult