Endoscopy 2004; 36(11): 1001-1007
DOI: 10.1055/s-2004-825962
The Expert Approach Section
© Georg Thieme Verlag Stuttgart · New York

Balloon Dilation of Ileocolonic Strictures in Crohn’s Disease

B.  P.  Saunders1 , G.  J.  E.  Brown1 , M.  Lemann2 , P.  Rutgeerts3
  • 1Wolfson Unit for Endoscopy, St. Mark’s Hospital, Harrow, Middlesex, UK
  • 2Department of Gastroenterology, Hôpital Saint-Louis, Paris, France
  • 3Department of Internal Medicine, Gastroenterology, University Hospital St. Rafael, Leuven, Belgium
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Publikationsverlauf

Publikationsdatum:
02. November 2004 (online)

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Objectives

Crohn’s disease is characterized by chronic, recurrent, transmural inflammation, which as a consequence of partial healing and localized fibrosis may lead to intestinal stricture formation (see Figure [1 a]). Following resectional surgery, recurrence of Crohn’s disease at the anastomosis or in the neo-terminal ileum may lead to stenosis. Treatment options for ileocolonic strictures include:

Figure 1 Endoscopic view of a Crohn’s stricture at an ileocolonic anastomosis: a before dilation; b ”through the balloon” view during dilation; c after dilation.

surgery (resection or stricturoplasty), anti-inflammatory medical therapy, and endoscopic balloon dilation.

Balloon dilation is an attractive first-line therapy as it is a minimally invasive approach which preserves intestinal length and function. Challenges for the endoscopist include:

appropriate selection of cases for dilation, achieving endoscopic access, successful passage of the balloon catheter through the endoscope and across the stricture, and obtaining adequate dilatation while minimizing the risk of major complications.

References

B. P. Saunders, M. D.

Wolfson Unit for Endoscopy, St. Mark's Hospital

Watford Rd · Harrow · Middlesex HA1 3UJ · UK

Fax: +44-20-84233588

eMail: b.saunders@ic.ac.uk