scholarly journals NSAIDs-Related Pyloroduodenal Obstruction and Its Endoscopic Management

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Mohd Talha Noor ◽  
Pankaj Dixit ◽  
Rakesh Kochhar ◽  
Birinder Nagi ◽  
Usha Dutta ◽  
...  
Keyword(s):  
Treatment Period ◽  
Balloon Dilatation ◽  
Outlet Obstruction ◽  
Endoscopic Management ◽  
Common Site ◽  
Related Complication ◽  
Endoscopic Balloon Dilatation ◽  
The Mean ◽  
Endoscopic Balloon

Endoscopic balloon dilatation (EBD) has important role in the management of benign gastric outlet obstruction. Although there are many reports on the role of EBD in the management of corrosive-induced and peptic benign GOO, there is scanty data on its role in the management of NSAID-induced GOO. We report 10 cases of NSAID-induced pyloroduodenal obstruction and their endoscopic management. The most common site of involvement was duodenum (5/10) followed by both pylorus and duodenum (4/10) and pylorus (1/10). Most of the strictures were short web-like, and the mean (SD) number of stricture was 2.0 (0.94). Endoscopic balloon dilatation was successful in 90% (9/10) cases requiring mean (SD) of 2.0 (1.6) sessions of dilatation to achieve target diameter of 15 mm and mean (SD) of 5.3 (2.7) sessions to maintain it over a treatment period of 4.5 months (IQR 2–15 months). There was no procedure-related complication or mortality.

scholarly journals Clinical profile and outcomes of opioid abuse gastroenteropathy: an underdiagnosed disease entity

2020 ◽  
Vol 18 (2) ◽  
pp. 238-244
Author(s):  
Ramit Mahajan ◽  
Yogesh Gupta ◽  
Arshdeep Singh ◽  
Pulkit Dhiman ◽  
Vandana Midha ◽  
...  
Keyword(s):  
Small Bowel ◽  
Balloon Dilatation ◽  
Outlet Obstruction ◽  
Opioid Abuse ◽  
Response To Treatment ◽  
Deficiency Anemia ◽  
Duration Of Symptoms ◽  
Endoscopic Balloon Dilatation ◽  
The Mean ◽  
Endoscopic Balloon

Background/Aims: Opioid-induced bowel dysfunction includes nausea, vomiting, constipation and abdominal distension. We describe patients presenting with gastrointestinal (GI) ulcers and ulcerated strictures secondary to opioid abuse, an entity not well described in literature.Methods: This retrospective observational study included patients with opioid abuse gastroenteropathy presenting to Dayanand Medical College and Hospital, Ludhiana, India between January 2013 and December 2018. Opioid abuse gastroenteropathy was defined as gastric or small bowel ulcers and ulcerated strictures in patients abusing opioids, where all other possible etiologies of GI ulcers/strictures were excluded. Clinical, biochemical, endoscopic, radiological and histological parameters as well as response to treatment were assessed.Results: During the study period, 20 patients (mean age, 38.5±14.2 years; 100% males) were diagnosed to have opioid induced GI ulcers and/or ulcerated strictures. The mean duration of opioid consumption was 6.2±3.4 years. The mean duration of symptoms at presentation was 222.1±392.3 days. Thirteen patients (65%) had gastroduodenal involvement, 6 (30%) had a jejunoileal disease and 1 (5%) had an ileocecal stricture. Two patients (10%) presented with upper GI bleeding, 11 (55%) had features of gastric outlet obstruction and 7 (35%) presented with small bowel obstruction. Abdominal pain and iron deficiency anemia were the most common presentations. Only 1 patient (5%) responded to proton pump inhibitors, 3 (15%) had a lasting response to endoscopic balloon dilatation, while all other (80%) required surgical intervention.Conclusions: Opioid abuse gastroenteropathy presents as ulcers and ulcerated strictures which respond poorly to medical management and endoscopic balloon dilatation. A majority of these cases need surgical intervention.

scholarly journals Long-term Results of Endoscopic Balloon Dilatation for Gastric Outlet Obstruction Caused by Peptic Ulcer Disease

2019 ◽  
Vol 11 (4) ◽  
pp. 218-224 ◽  
Author(s):  
Ehsan Zare ◽  
Hadi Raeisi ◽  
Behnam Honarvar ◽  
Kamran B. Lankarani
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Balloon Dilatation ◽  
Outlet Obstruction ◽  
Long Term Results ◽  
Current Status ◽  
Ulcer Disease ◽  
Endoscopic Balloon Dilatation ◽  
Endoscopic Balloon

BACKGROUND Gastric outlet obstructions (GOO) is a disabling complication of peptic ulcer disease (PUD). The introduction of endoscopic through the scope balloon dilatation (EBD) has eased the management but there are few reports on the long term results of this modality of treatment on patients’ symptoms. METHODS Over a period of 4 years from January 2012 to December 2015 in two major referral hospitals affiliated to Shiraz university, medical endoscopy reports were reviewed retrospectively to identify those who received EBD for the treatment of GOO due to PUD .All of these patients were recalled and their current status were evaluated. RESULTS 22 consecutive patients with symptomatic GOO secondary to benign stricture underwent endoscopic balloon dilatation by a single operator. Of them, 14 had balloon dilatation twice and 6 had ballooning three times. The interval between the first referral and the last follow-up was 25.2 ± 10.3 (min: 4.8 max:43.4) months. The averages of maximum balloon size were 14.4 ± 5 mm in the first session, 14.3 ± 3.1mm in the second session, and 16 ± 2.4 mm in the third session. 73% of the patients had a significant improvement in clinical symptom with two sessions of EBD and did not require repeat dilatation. CONCLUSION EBD is a safe and efficient method in the management of GOO with good long term results.

scholarly journals Endoscopic balloon dilatation is an effective management strategy for caustic-induced gastric outlet obstruction: a 15-year single center experience

2019 ◽  
Vol 07 (01) ◽  
pp. E53-E61 ◽  
Author(s):  
Rakesh Kochhar ◽  
Sarthak Malik ◽  
Yalaka Reddy ◽  
Bipadabhanjan Mallick ◽  
Narendra Dhaka ◽  
...  
Keyword(s):  
Gastric Outlet Obstruction ◽  
Balloon Dilatation ◽  
Clinical Success ◽  
Tertiary Care ◽  
Outlet Obstruction ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Endoscopic Balloon Dilatation ◽  
Endoscopic Balloon

Abstract Background and study aims There is sparse data on the endoscopic management of caustic-induced gastric outlet obstruction (GOO). The present retrospective study aimed to define the response to endoscopic balloon dilatation (EBD) in such patients and their long-term outcome. Patients and methods The data from symptomatic patients of caustic-induced GOO who underwent EBD at our tertiary care center between January 1999 and June 2014 were retrieved. EBD was performed using wire-guided balloons in an incremental manner. Procedural success and clinical success of EBD were evaluated, including complications and long-term outcome. Results A total of 138 patients were evaluated of whom 111 underwent EBD (mean age: 30.79 ± 11.95 years; 65 male patients; 78 patients with isolated gastric stricture; 33 patients with both esophagus plus gastric stricture). The initial balloon diameter at the start of dilatation, and the last balloon diameter were 9.6 ± 2.06 mm (6 – 15 mm) and 14.5 ± 1.6 mm (6 – 15 mm), respectively. Procedural and clinical success was achieved in 95 (85.6 %) and 108 (97.3 %) patients, respectively, requiring a mean (SD) of 5.3 (2.6) and 7.21 (3.86) sessions, respectively. Patients with isolated gastric obstruction had a better response than those with combined esophagus and gastric stricture. Minor complications such as self-limited pain or bleeding were seen in 18 (16.2 %) and 16 (14.4 %), respectively. Perforation occurred in two patients. Over a follow-up period of 98 months, there were no recurrences. Conclusion Caustic-induced GOO can be successfully managed using EBD with 97.3 % clinical success.

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