The response of Crohn's strictures to endoscopic balloon dilation.
BACKGROUND
Endoscopic balloon dilation has been shown to be an alternative to surgery in the treatment of Crohn's symptomatic strictures.


OBJECTIVE
To analyse the impact of the type of the strictures -de novo or anastomotic - their location and their length on the outcome of endoscopic balloon dilation.


METHODS
Between December 1999 and June 2008, 55 patients underwent 93 balloon dilations for 74 symptomatic strictures. One stricture was located in the duodenum, 39 strictures were in the terminal ileum, 17 at the ileocoecal anastomosis after a preceding resection and 17 in the colon.


RESULTS
Endoscopic treatment was successful in 76% of the patients during an observation period of 44 (1-103) months. Of the patients, 24% required surgery. All patients who underwent surgery had de novo strictures in the terminal ileum. These strictures were significantly longer compared with the ileal strictures that responded to endoscopic treatment [7.5 (1-25) cm vs. 2.5 (1-25) cm; P = 0.006].


CONCLUSIONS
The long-term success of endoscopic balloon dilation depends on the type of the strictures, their location and their length. Failure of endoscopic treatment was observed only in long-segment strictures in the terminal ileum.
Mueller
T
T
Department of Gastroenterology, Klinikum Memmingen, Memmingen, Germany. tomx113@t-online.de
Rieder
B
B
Bechtner
G
G
Pfeiffer
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods; D003251:Constriction, Pathologic / Q000628:therapy*; D003424:Crohn Disease / Q000473:pathology / Q000628:therapy*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult