title: 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.
  
  
  METHODS
  Tertiary care center in India.
  
  
  METHODS
  Retrospective analysis of data.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Early EBD by an expert endoscopist is a safe and effective treatment modality in the management of caustic-induced GOO.
authors.affiliation: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. dr_kochhar@hotmail.com
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kochhar
authors.forename: Kuchhangi Sureshchandra
authors.initials: KS
authors.lastname: Poornachandra
authors.forename: Usha
authors.initials: U
authors.lastname: Dutta
authors.forename: Amit
authors.initials: A
authors.lastname: Agrawal
authors.forename: Kartar
authors.initials: K
authors.lastname: Singh
mesh_terms: D000328:Adult; D002057:Burns, Chemical / Q000150:complications / Q000473:pathology / Q000628:therapy*; D002404:Catheterization / Q000379:methods*; D002424:Caustics / Q000633:toxicity*; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000628:therapy*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D011708:Pylorus / Q000293:injuries* / Q000473:pathology; D013270:Stomach / Q000293:injuries* / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002424:Caustics