Adult Duodenal Web: Endoscopic Management

Rosario, Manuel T.; Alves, Isabel; Carneiro, António Vaz; Ventura, Albania; Sales-Luis, A.

doi:10.1055/s-2007-1010373

Cited by 11 publications

(6 citation statements)

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“…Nose et al (12) reported on the use of a snare electrocoagulation technique to resect the membrane by trapping it into a suction sleeve, however, such approach was considered to be effective only for "windsock" deformity. There are other clinicians reported membrane resection using laser, papillotome or polypectomy snare via gastroscope in adults (13)(14)(15). Nevertheless, considering the narrow space and thinner walls of duodenum in children, membranectomy cutting technique without balloon dilatation is potentially hazardous.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Balloon Dilatation-Based Membrane Resection for Membranous Duodenal Stenosis: A Feasibility and Safety Study (With Video)

Wang

Lin

Liu

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: Surgery is generally considered as the first-line therapy for membranous duodenal stenosis (MDS) in children. However, abdominal surgery leaves permanent scars and may even cause intestinal adhesion. Therefore, an effective, safe, and minimally invasive method is urgently needed. This study aimed to evaluate the safety, efficacy, and feasibility of endoscopic balloon dilatation-based membrane resection (EBD-MR) to treat MDS in children. Methods: We retrospectively reviewed patients with MDS treated with EBD-MR in Shanghai Children’s Hospital from May 2016 to August 2021. Primary study outcome was clinical success, defined as weight gain and complete remission of vomiting, without the need for repeat endoscopic or surgical intervention during follow-up. Secondary outcomes included technical success, diameter changes of the membrane opening, and adverse events. Results: Nineteen children (9 females, mean age 14.5 ± 11.2 months) received endoscopic treatment for MDS, and clinical success was achieved in 18 of 19 patients (94.7%). No bleeding, perforation, and jaundice occurred. Diameters of the membrane opening increased from 2.97 ± 2.87 mm to 9.78 ± 1.27 mm after the treatment, symptoms of vomiting did not reappear during 10–73 months of follow-up, and body mass index of the children increased from 14.9 ± 2.2 kg/m2 (pre-operation) to 16.2 ± 3.7 kg/m2 (6 months after operation). One patient required surgical revision because of existence of a second web; three patients received 2–3 sessions of endoscopic treatment to obtain the final remission. Conclusions: The EBD-MR technique is safe, effective, and feasible for MDS, which provided an excellent alternative to surgical management for the disease in pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Balloon Dilatation-Based Membrane Resection for Membranous Duodenal Stenosis: A Feasibility and Safety Study (With Video)

Wang

Lin

Liu

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…Duodenal webs are thought to arise from incomplete recanalization of the duodenal lumen during the fourth and fifth weeks of gestation. Presentation is typically early in life with evidence of proximal bowel obstruction; however, presentation late in adulthood has been reported (5,6).…”

Section: Discussionmentioning

confidence: 99%

“…Advancement of therapeutic endoscopic techniques has revolutionized the approach to duodenal webs in adults. Excellent results have been accomplished with a combination of dilation and laser, papillotome, or sphincterotome, with follow-up extending to 18 months (5,6). It has been suggested that therapeutic endoscopy may be the preferred method of treatment for duodenal webs in adults because of its efficacy, relative simplicity, safety, and lack of invasive-ness (6).…”

Section: Discussionmentioning

confidence: 99%

“…To date, reports of endoscopic treatment for duodenal webs have been free of significant complications. In particular, the development of posttreatment strictures has not been reported (2,(4)(5)(6)9). It has been proposed that the use of radial incisions for endoscopic treatment of duodenal web is less apt to lead to stricture formation than circumferential excision (4).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic Dilation and Partial Resection of a Duodenal Web in an Infant

Beeks¹,

Gosche²,

Giles

et al. 2009

J. pediatr. gastroenterol. nutr.

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“…After identification, endoscopic diverticulectomy or diverticulotomy can be performed, and many techniques have been described. A variety of devices have been reported, including standard polypectomy snares, needle-knife papillotomes, standard sphincterotomes, and endoscopic submucosal dissection knives 6, 7, 8. After resection or incision, the endoscopist should be aware that these lesions are known to be very vascular and are prone to both immediate and delayed bleeding.…”

mentioning

confidence: 99%