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Balloon dilatation of esophageal stenosis in children
1Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City 52242.
Insights
Balloon dilatation is a safe and effective treatment for benign esophageal strictures in children. This minimally invasive procedure offers long-term resolution for most pediatric patients, making it a primary therapeutic option.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
- Pediatric Surgery
Background:
- Benign esophageal strictures are a common condition in pediatric patients.
- Current treatment options for pediatric esophageal strictures can be invasive and carry risks.
- Balloon dilatation is an established therapy for adults but less studied in pediatric populations.
Purpose of the Study:
- To evaluate the safety and efficacy of balloon dilatation for benign esophageal strictures in infants and children.
- To assess the long-term outcomes of balloon dilatation in pediatric patients with various types of esophageal strictures.
Main Methods:
- A retrospective review of 20 consecutive pediatric patients undergoing balloon dilatation for benign esophageal strictures.
- Strictures treated included post-surgical anastomotic sites, Nissen fundoplications, and non-anastomotic causes.
- Dilatations were primarily performed on an outpatient basis without anesthesia.
Main Results:
- All 20 patients showed immediate improvement following balloon dilatation.
- Long-term resolution was achieved in most cases within three or fewer procedures.
- A subset of patients with specific conditions (e.g., esophageal atresia, chronic esophagitis) required prolonged treatment.
- No significant complications were reported during the study period.
Conclusions:
- Balloon dilatation is an effective and safe therapeutic option for benign esophageal stenosis in children.
- This endoscopic approach should be considered a first-line treatment before other interventions.
- The procedure demonstrates favorable outcomes with minimal complications in the pediatric population.
Abstract:
Balloon dilatation of benign esophageal strictures is an accepted mode of therapy in adults. This report describes balloon dilatation in 20 consecutive infants and children. The lesions treated include 11 strictures at surgical anastomotic sites, seven restrictive Nissen fundoplications, and three nonanastomotic esophageal strictures. One patient had two lesions. Most dilatations were performed on an outpatient basis without anesthesia. All strictures responded immediately to dilatation. In most cases, long-term resolution occurred after three or fewer procedures. A subgroup of patients was identified in which a prolonged course of treatment was needed. These included patients with long strictures due to esophageal atresia, patients with chronic severe esophagitis, and patients with strictures at the site of esophageal perforation. No significant complications were encountered. Balloon dilatation of esophageal stenosis in children is effective and safe and should be considered before other methods of treatment are used.