Endoscopic hydrostatic balloon dilation of ulcer-induced pyloric stenosis in rheumatoid arthritis and secondary amyloidosis.
We describe a 50-year-old Japanese woman with rheumatoid arthritis who presented with near-complete gastric outlet obstruction. The patient also suffered from secondary gastrointestinal and cardiac amyloidosis. Gastroscopy revealed multiple huge gastric antral ulcers in which amyloid deposits were identified on histologic examination. The ulcers became scars after treatment with omeprazole, which cause in severe pyloric stenosis. Endoscopic hydrostatic balloon dilation under fluoroscopic guidance was performed twice for 10 min. The pyloric outlet remained sufficiently patent 22 months later.
Hizawa
K
K
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Maidashi 3-1-1, Higashi-Ku, Fukuoka 812-82, Japan.
Ohta
Y
Y
Satou
H
H
Aoyagi
K
K
Eguchi
K
K
Fujishima
M
M
D000686:Amyloidosis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D001706:Biopsy; D009202:Cardiomyopathies / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D002404:Catheterization / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005773:Gastroscopy / Q000379:methods; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006874:Hydrostatic Pressure; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D010289:Parenteral Nutrition, Total; D011707:Pyloric Stenosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013276:Stomach Ulcer / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D005938:Glucocorticoids; D009853:Omeprazole