TITLE

Endoscopic Treatment Of Recurrent Gastro-Gastric Stricture Following Revision Of A Divided Roux-En-Y Gastric Bypass

AUTHOR(S)
Bal, Bikram S.; Lakhani, Shilen V.; Shah, Hiral N.; Finelli, Frederick C.; Koch, Timothy R.
PUB. DATE
January 2009
SOURCE
Internet Journal of Gastroenterology;2009, Vol. 8 Issue 1, p10
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Balloon dilation as a treatment for post-surgical anastomotic strictures is minimally invasive and relatively safe. The benefit of "through-the-scope" endoscopic balloon dilation has a reported long-term improvement for patient symptoms. This is a case report of a patient who developed severe dysphagia following revision of a divided Roux-en-Y gastric bypass with formation of a gastro-gastric anastomosis. The patient developed a gastro-gastric anastomotic stricture that rapidly recurred following multiple endoscopic dilations with balloon dilators. Following repeat endoscopic dilations, the anastomotic stricture was treated by submucosal injections of triamcinolone into the stricture, using a protocol described for esophageal strictures. Because this treatment prevented recurrent symptoms, she did not require repeat dilation for 3 months, prior to small intestinal transplantation. Repeat upper endoscopy prior to transplantation surgery revealed a patent gastro-gastric anastomosis. This case report demonstrates that injection of corticosteroid directly into a surgical anastomotic stricture improves the long-term efficacy of dilation.
ACCESSION #
47682715

 

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