title: Is side-viewing endoscope assisted balloon dilatation better for corrosive gastric outlet obstruction?
abstract: BACKGROUND
  Endoscopic balloon dilatation (EBD) is an effective therapy for caustic-induced gastric outlet obstruction (GOO). Gaining access to the stricture site is the most important step. It is sometimes difficult to negotiate a balloon through the stricture with a front-viewing endoscope due to deformed anatomy of stomach. To overcome this technical difficulty, a side-viewing endoscope can be used. There is limited data regarding the use of side-viewing endoscopes in EBD. We here report on the short-term efficacy and safety of EBD in caustic-induced GOO. In technically difficult cases, a side-viewing endoscope was used for EBD and its efficacy and safety were assessed.
  
  
  METHODS
  The study included 25 patients with caustic-induced GOO. Patients underwent EBD using a through-the-scope balloon. Initial balloon dilatation was performed with a front-viewing endoscope. A side-viewing endoscope was used where negotiation across the stricture failed with a front-viewing endoscope. Dilatation was started at 8 mm diameter and was performed at 1-week intervals. The end point of dilatation was 15 mm diameter.
  
  
  RESULTS
  In 18 patients successful balloon dilatation was possible with a front-viewing endoscope. A side-viewing endoscope was used in six patients as negotiation across the stricture was not possible with a front-viewing endoscope. In all six patients negotiation across the stricture followed by successful dilatation was successful with a side-viewing endoscope. Of the 25 patients included in this study, 24 (96%) achieved procedural success (18 with a front-viewing endoscope and 6 with a side-viewing endoscope) in 3-9 sessions.
  
  
  CONCLUSIONS
  Our results show that EBD is a safe and effective option for caustic-induced GOO and in difficult cases a side-viewing endoscope can be used to achieve technical success.
authors.affiliation: Department of Gastroenterology, SMS Medical College, Prashant Katiyar, Room 194, RD Hostel, Jaipur, Rajasthan, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Katiyar
authors.forename: Sandeep
authors.initials: S
authors.lastname: Nijhawan
authors.forename: Vimal
authors.initials: V
authors.lastname: Saradava
authors.forename: Neeraj
authors.initials: N
authors.lastname: Nagaich
authors.forename: Gaurav
authors.initials: G
authors.lastname: Gupta
authors.forename: Amit
authors.initials: A
authors.lastname: Mathur
authors.forename: Subhash
authors.initials: S
authors.lastname: Nepalia
keywords: Gastric outlet obstruction; caustic; endoscopic balloon dilatatation