Endoscopic balloon dilation for management of stricturing Crohn’s disease in children  

作　　者：Brianna McSorley Robert A Cina Candi Jump Johanna Palmadottir J Antonio Quiros 

机构地区：[1]Department of Pediatrics,Medical University of South Carolina,Charleston,SC 29425,United States [2]Department of Surgery,Medical University of South Carolina,Charleston,SC 29425,United States [3]Department of Pediatric Gastroenterology,Medical University of South Carolina,Charleston,SC 29425,United States [4]Department of Pediatric Gastroenterology,MUSC Children's Hospital,Charleston,SC 29425,United States [5]Department of Pediatric Gastroenterology and Nutrition,Mount Sinai Kravis Children's Hospital,New York,NY 10029,United States

出　　处：《World Journal of Gastrointestinal Endoscopy》2021年第9期382-390,共9页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Crohn’s disease(CD)has a multitude of complications including intestinal strictures from fibrostenotic disease.Fibrostenotic disease has been reported in 10%-17%of children at presentation and leads to surgery in 20%-50%of cases within ten years of diagnosis.When symptoms develop from these strictures,the treatment in children has primarily been surgical resection.Endoscopic balloon dilation(EBD)has been shown to be a safe and efficacious alternative to surgery in adults,but evidence is poor in the literature regarding its safety and efficacy in children.AIM To evaluate the outcomes of children with fibrostenosing CD who underwent EBD vs surgery as a treatment.METHODS In a single-center retrospective study,we looked at pediatric patients(ages 0-18)who carry the diagnosis of CD,who were diagnosed after opening a dedicated Inflammatory Bowel Disease clinic on July 1,2012 through May 1,2019.We used diagnostic codes through our electronic medical record to identify patients with CD with a stricturing phenotype.The type of intervention for patients’strictures was then identified through procedural and surgical billing codes.We evaluated their demographics,clinical variables,whether they underwent EBD vs surgery or both,and their clinical outcomes.RESULTS Of the 139 patients with CD,25(18%)developed strictures.The initial intervention for a stricture was surgical resection in 12 patients(48%)and EBD in 13 patients(52%).However,4(33%)patients whom initially had surgical resection required follow up EBD,and thus 17 total patients(68%)underwent EBD at some point in their treatment process.For those 8 patients who underwent successful surgical resection alone,4 of these patients(50%)had a fistula present near the stricture site and 4(50%)had strictures greater than 5 cm in length.All patients who underwent EBD had no procedural complications,such as a perforation.Twenty-two(88%)of the treated strictures were successfully managed by EBD and did not require any further surgical intervention during our follow u

关 键 词：Crohn’s disease Intestinal strictures Endoscopic dilation PEDIATRICS Endoscopic balloon dilation 

分 类 号：R726.5[医药卫生—儿科]