Tubercular versus Crohn’s ileal strictures: role of endoscopic balloon dilatation without fluoroscopy

BACKGROUND: Benign ileal strictures can cause considerable morbidity and they have been conventionally treated with surgery. The aim of this study was to report our experience of endoscopic balloon dilatation (EBD) in patients with terminal ileal strictures because of Crohn’s disease and tuberculosi...

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Autores principales: Singh Rana, Surinder, Kumar Bhasin, Deepak, Rao, Chalapathi, Singh, Kartar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959941/
https://www.ncbi.nlm.nih.gov/pubmed/24714760
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author Singh Rana, Surinder
Kumar Bhasin, Deepak
Rao, Chalapathi
Singh, Kartar
author_facet Singh Rana, Surinder
Kumar Bhasin, Deepak
Rao, Chalapathi
Singh, Kartar
author_sort Singh Rana, Surinder
collection PubMed
description BACKGROUND: Benign ileal strictures can cause considerable morbidity and they have been conventionally treated with surgery. The aim of this study was to report our experience of endoscopic balloon dilatation (EBD) in patients with terminal ileal strictures because of Crohn’s disease and tuberculosis. METHODS: Over the last 8 years, 9 patients (6 males; mean age 39.7±13.2 years) with benign terminal ileal strictures were treated by EBD using a colonoscope and through-the-scope controlled radial expansion balloon dilators. RESULTS: The etiology of benign ileal stricture was Crohn’s disease in 5 and tuberculosis in 4 patients. All the patients with Crohn’s disease had no or partial response to 4 weeks of steroid therapy and there were no mucosal ulcerations on ileoscopy. Three patients with ileal strictures due to tuberculosis underwent dilatation after completion of the antitubercular therapy (ATT) while one patient required dilatation 3 months after starting ATT. All patients had single ileal stricture with length of stricture ranging from 0.6-1.8 cm. EBD was successful in all 9 patients with a median number of dilating sessions required of 2 (range: 1-5 sessions). Patients with Crohn’s disease required more endoscopic sessions as compared to patients with tuberculosis but this difference was not statistically significant (mean number of session being 3.0±1.58 vs. 1.75±0.5 sessions respectively; P=0.1). One patient with ileal tuberculosis had enterolith proximal to the stricture that could be removed with dormia. There were no complications of the endoscopic procedure. CONCLUSIONS: EBD is an effective, safe, and minimally invasive treatment modality for benign ileal strictures.
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spelling pubmed-39599412014-04-07 Tubercular versus Crohn’s ileal strictures: role of endoscopic balloon dilatation without fluoroscopy Singh Rana, Surinder Kumar Bhasin, Deepak Rao, Chalapathi Singh, Kartar Ann Gastroenterol Original Article BACKGROUND: Benign ileal strictures can cause considerable morbidity and they have been conventionally treated with surgery. The aim of this study was to report our experience of endoscopic balloon dilatation (EBD) in patients with terminal ileal strictures because of Crohn’s disease and tuberculosis. METHODS: Over the last 8 years, 9 patients (6 males; mean age 39.7±13.2 years) with benign terminal ileal strictures were treated by EBD using a colonoscope and through-the-scope controlled radial expansion balloon dilators. RESULTS: The etiology of benign ileal stricture was Crohn’s disease in 5 and tuberculosis in 4 patients. All the patients with Crohn’s disease had no or partial response to 4 weeks of steroid therapy and there were no mucosal ulcerations on ileoscopy. Three patients with ileal strictures due to tuberculosis underwent dilatation after completion of the antitubercular therapy (ATT) while one patient required dilatation 3 months after starting ATT. All patients had single ileal stricture with length of stricture ranging from 0.6-1.8 cm. EBD was successful in all 9 patients with a median number of dilating sessions required of 2 (range: 1-5 sessions). Patients with Crohn’s disease required more endoscopic sessions as compared to patients with tuberculosis but this difference was not statistically significant (mean number of session being 3.0±1.58 vs. 1.75±0.5 sessions respectively; P=0.1). One patient with ileal tuberculosis had enterolith proximal to the stricture that could be removed with dormia. There were no complications of the endoscopic procedure. CONCLUSIONS: EBD is an effective, safe, and minimally invasive treatment modality for benign ileal strictures. Hellenic Society of Gastroenterology 2013 /pmc/articles/PMC3959941/ /pubmed/24714760 Text en Copyright: © Hellenic Society of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Singh Rana, Surinder
Kumar Bhasin, Deepak
Rao, Chalapathi
Singh, Kartar
Tubercular versus Crohn’s ileal strictures: role of endoscopic balloon dilatation without fluoroscopy
title Tubercular versus Crohn’s ileal strictures: role of endoscopic balloon dilatation without fluoroscopy
title_full Tubercular versus Crohn’s ileal strictures: role of endoscopic balloon dilatation without fluoroscopy
title_fullStr Tubercular versus Crohn’s ileal strictures: role of endoscopic balloon dilatation without fluoroscopy
title_full_unstemmed Tubercular versus Crohn’s ileal strictures: role of endoscopic balloon dilatation without fluoroscopy
title_short Tubercular versus Crohn’s ileal strictures: role of endoscopic balloon dilatation without fluoroscopy
title_sort tubercular versus crohn’s ileal strictures: role of endoscopic balloon dilatation without fluoroscopy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959941/
https://www.ncbi.nlm.nih.gov/pubmed/24714760
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