Operative Endoscopy in Pediatric Inflammatory Bowel Disease

  • Erminia Romeo
  • Filippo Torroni
  • Luigi Dall’Oglio
Chapter

Abstract

Crohn’s disease (CD) is a chronic relapsing disease with a long-term course that is usually progressive and most patients with CD undergo intestinal surgery during their lifetime. Endoscopic balloon dilation (EBD) is an alternative to surgery. Many factors are involved in determining endoscopic dilation outcomes. The length of the strictures was found to be a determinant of the outcome of balloon dilation in the previously published systematic review, where stricture length of >4 cm was associated with a poor outcome. Catheters used for gastrointestinal strictures dilation are: an over-the-wire balloon catheter and a through-the-scope balloon catheter. Through-the-scope balloon catheters tend to be selected for almost EBD procedures because of their simplicity and safety.

References

  1. 1.
    Despott EJ, Gupta A, Burling D, et al. Effective dilation of small bowel strictures by double-balloon enteroscopy in patients with symptomatic Crohn’s disease. Gastrointest Endosc. 2009;70:1030–6.CrossRefGoogle Scholar
  2. 2.
    Sunada K, Shinozaki S, Nagayama M, et al. Long-term outcomes in patients with small intestinal strictures secondary to Crohn’s disease after double-balloon endoscopy-assisted balloon dilation. Inflamm Bowel Dis. 2016;22:380–6.CrossRefGoogle Scholar
  3. 3.
    Hirai F. Current status of endoscopic balloon dilation for Crohn’s disease. Intest Res. 2017;15:166–73.CrossRefGoogle Scholar
  4. 4.
    Navaneethan U, Lourdusamy V, Njei B, et al. Endoscopic balloon dilation in the management of strictures in Crohn’s disease: a systematic review and meta-analysis of non-randomized trials. Surg Endosc. 2016;30:5434–43.CrossRefGoogle Scholar
  5. 5.
    Morar PS, Faiz O, Warusavitarne J, et al. Systematic review with meta-analysis: endoscopic balloon dilatation for Crohn’s disease strictures. Aliment Pharmacol Ther. 2015;42:1137–48.CrossRefGoogle Scholar
  6. 6.
    Mueller T, Rieder B, Bechtner G, et al. The response of Crohn’s strictures to endoscopic balloon dilation. Aliment Pharmacol Ther. 2010;31:634–9.CrossRefGoogle Scholar
  7. 7.
    Levine RA, Wasvary H, Kadro O. Endoprosthetic management of refractory ileocolonic anastomotic strictures after resection for Crohn’s disease: report of nine-year follow-up and review of the literature. Inflamm Bowel Dis. 2012;18(3):506–12.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Erminia Romeo
    • 1
  • Filippo Torroni
    • 1
  • Luigi Dall’Oglio
    • 1
  1. 1.Digestive Surgery and Endoscopy UnitBambino Gesù Children’s HospitalRomeItaly

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