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* = Presenting author

P532 Effectiveness of balloon dilation using single balloon enteroscopy in multiple small bowel stricture

J.-S. Kim*1, Y.-S. Cho2

1Catholic University of Korea, Department of Internal Medicine, Seoul, South Korea, 2Catholic University of Korea, Department of Internal Medicine, Seoul, South Korea

Background

Despite optimised medical treatment, Crohn’s disease can cause gastrointestinal strictures, which requires surgical intervention. Endoscopic balloon dilatation has been reported as an alternative method to avoid surgery. However, little is known about the effectiveness of balloon dilatation in Crohn’s disease patients with multiple small bowel strictures. We report our experiences and outcome of balloon dilatation in multiple small bowel strictures.

Methods

From May 2012 to February 2015, patients with multiple small bowel strictures who showed obstructive symptom were enrolled. The effectiveness and outcomes of balloon dilatation was retrospectively evaluated. Multiple small bowel strictures defined as at least 3 stricture lesions, confirmed by abdomen CT or CT enterography. Dilatation was performed using a single balloon enteroscopy. The balloon was introduced into the stricture using a guide-wire under radiological control. Dilatation was performed until a balloon diameter of 15 mm had been reached. Passage of the enteroscope through the stricture after dilatation was attempted in all patients and was used to define therapeutic success.

Results

In total, 8 patients with multiple small bowel stricture enrolled this study. Successful dilatation was achieved in 7 of 8 patients (87.5%). In 2 patients, 5 stricture points were successfully dilated. In 4 patients, 4 stricture points were successfully dilated, and in 1 patient, 3 stricture points were successfully dilated. However, unexpected perforation occurred in 1 patient immediately after balloon dilatation was referred to surgery. As to stricture, primary success was achieved in 29 of the 30 strictures (96.6%). During the mean follow-up period of 18 months, there was no significant obstructive symptom in 6 patients, but 1 patient complained of recurrence of obstructive symptom, and redilatation was performed.

Conclusion

Balloon dilatation using enteroscopy in Crohn’s disease patients with multiple small bowel stricture and obstructive symptoms seems to be feasible. In 7 of 8 patients, surgery was avoided, during a mean follow-up of 18 months.