Early endoscopic balloon dilation in caustic-induced gastric injury.
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.
Kochhar
Rakesh
R
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. dr_kochhar@hotmail.com
Poornachandra
Kuchhangi Sureshchandra
KS
Dutta
Usha
U
Agrawal
Amit
A
Singh
Kartar
K
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
D002424:Caustics