Balloon dilation when using double-balloon enteroscopy for small-bowel strictures associated with ischemic enteritis

Nishimura, Naoyuki; Yamamoto, Hironori; Yano, Tomonori; Hayashi, Yoshikazu; Satō, Hiroyuki; Mıura, Yoshimasa; Shinhata, Hakuei; Sunada, Keijiro; Sugano, Kentaro

doi:10.1016/j.gie.2011.07.024

Cited by 20 publications

(17 citation statements)

References 23 publications

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“…If the accessory channel diameter of the balloon endoscope is not less than 2.8 mm, balloon dilation for stenosis can be carried out by inserting a balloon dilator. In the case where the accessory channel diameter of the diagnostic scope is smaller, balloon dilation can be carried out by inserting a balloon dilator under fluoroscopic guidance after removing the scope, leaving the overtube and guidewire in place …”

Section: Commentarymentioning

confidence: 99%

Clinical Practice Guideline for Enteroscopy

Yamamoto

Ogata

Matsumoto

et al. 2017

Digestive Endoscopy

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125

158

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Management of small bowel diseases has evolved since the advent of capsule endoscopy (CE) and balloon‐assisted enteroscopy (BAE). One of the most common indications for enteroscopy is obscure gastrointestinal bleeding (OGIB), followed by small bowel stenosis, tumors, and inflammatory bowel disease. Although enteroscopes have been regarded as useful tools, correct guidelines are required to ensure that we manipulate these enteroscopes safely and efficiently in clinical practice. Herein, the Japanese Gastroenterological Endoscopy Society has developed ‘Clinical Practice Guidelines for Enteroscopy’ in collaboration with the Japanese Society of Gastroenterology, the Japanese Gastroenterological Association, and the Japanese Association for Capsule Endoscopy. These guidelines are based on the evidence available until now, but small bowel endoscopy is a relatively new technology, so the guidelines include recommendations based on a consensus reached among experts when the evidence has not been considered sufficient. These guidelines were not designed to be disease‐based, but focus on how we should use small bowel CE and BAE in everyday clinical practice.

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Section: Commentarymentioning

confidence: 99%

Clinical Practice Guideline for Enteroscopy

Yamamoto

Ogata

Matsumoto

et al. 2017

Digestive Endoscopy

Self Cite

125

158

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“…Signs appear during the post-thrombotic course, and the main triad of symptoms, which indicates the appearance of chronic intestinal obstruction as a result of intestinal stenosis, mainly occurs several weeks after revascularization (it varies from several days to months) [6]. Ischemic intestinal stenosis does meet the diagnostic criteria of ischemic enteritis, which can also be related to limited thrombosis or embolism [19,20]. However, in this research, we found that constant malnutrition with hypoproteinemia and hypoalbuminemia was another main clinical feature.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical resection is also the main strategy of intestinal enteritis [20]. An emerging role of balloon dilation for symptomatic intestinal stricture has also been reported and is considered to be a useful alternative to surgery when the length of the stricture is less than 3 cm [19]. However, small bowel strictures that are long (> 3 cm) may not be candidates for balloon dilation, and the length of the involved intestine in PIIS secondary to AMVT was longer than 3 cm in most patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile, Response to therapy and outcomes of post-ischemic intestinal stenosis Secondary to Acute Mesenteric Venous Thrombosis: a retrospective case series study

Sun

Wang

Chu

et al. 2020

Preprint

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Background Acute mesenteric venous thrombosis (AMVT) can not only cause acute bowel infarction but result in post-ischemic intestinal stenosis (PIIS), which is rarely reported. Methods Consecutive patients diagnosed with PIIS secondary to AMVT (during the post-thrombotic course, confirmed segmental bowel stenosis) from January 2010 to June 2018 were enrolled. We evaluated the clinical profile, response to therapy, and outcomes of this complication managed at the intestinal stroke center in China. Clinical data are retrospectively analyzed and Wilcoxon signed-rank test was used to evaluate the efficiency of conservative treatment. Results 42 patients with PIIS secondary to AMVT were evaluated. 20 (5-150) days after discharge for AMVT, symptoms of PIIS appeared, and the interval between symptom onset and consultation was 29.5 (2-180) days. In addition, abdominal pain (90.5%), abdominal distension (76.2%), weight loss (71.4%), and nausea or vomiting (54.8%) were the common presentations. Hypoproteinemia was observed in 61.9% of patients, while leukocytosis, anemia and electrolyte disorders were present in 11.9%, 45.2% and 35.7% of patients, respectively. CT excluded thrombosis recurrence and revealed extensive collateral circulation or portal cavernous transformation in 83.3% of patients. Enterography was required only in 81.0% of patients, with positive findings in all patients, including complete obstruction (23.5%), intestinal stricture (64.7%), and extensive mucosal erosion (11.8%). Prompt conservative treatment achieved significantly increases of albumin and pre-albumin levels and correction of electrolyte disorders (all p < 0.05). However, only 4 (9.5%) patients improved after conservative therapy and laparotomy was required in other patients. A median length of 20 (2-100) cm of involved bowel was resected, mainly involving the jejunum (76.3%). Only 1 patient died due to uncontrolled transverse colon bleeding, and other patients’ postoperative courses were uneventful. Conclusion During the post-thrombotic course, clinicians should be aware of the possibility of PIIS in patients with symptoms of ileus and hypoproteinemia. Patients may respond to conservative therapy; however, the majority of patients warrant surgical resection.

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“…DAE has also been used for therapy: retrieval of potentially harmful foreign bodies, especially retained CE [125], but also bezoars [126], needles [127], coins [128], gastric bands [129], dentures [130] and migrated stents [131]. Many SB strictures secondaries to NSAIDs, radiation, surgical anastomosis, or malignancy have been treated with balloon dilation [76,132,133] or stenting, using both over-the-wire or through-the-scope techniques [134][135][136]. DAE can also be used for percutaneous endoscopic jejunostomy [137] and SB intussusception [138].…”

Section: Miscelaneousmentioning

confidence: 99%

Small Bowel Enteroscopy – A Joint Clinical Guideline from the Spanish and Portuguese Small Bowel Study Groups

Pérez-Cuadrado-Robles

Pinho

González

et al. 2020

GE Port J Gastroenterol

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The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication and on its diagnostic and therapeutic yields. A set of recommendations were issued accordingly.

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Balloon dilation when using double-balloon enteroscopy for small-bowel strictures associated with ischemic enteritis

Cited by 20 publications

References 23 publications

Clinical Practice Guideline for Enteroscopy

Clinical Practice Guideline for Enteroscopy

Clinical Profile, Response to therapy and outcomes of post-ischemic intestinal stenosis Secondary to Acute Mesenteric Venous Thrombosis: a retrospective case series study

Small Bowel Enteroscopy – A Joint Clinical Guideline from the Spanish and Portuguese Small Bowel Study Groups

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