ENDOSCOPIC BALLOON DILATATION IN CHILDREN WITH PARTIAL GASTRIC OUTLET OBSTRUCTION

Aims:

To demonstrate our own experience with endoscopic balloon dilatation (EBD) in children with partial GOO caused by after ulcerous stenosis of the antral part of the stomach.

Methods:

From June 2013 to November 2018 we treated six children with diagnosis “GOO” caused by after ulcerous stenosis of the antrum. We offered EBD as an alternative to surgery. Endoscopic balloon dilation was performed under general anesthesia using endoscopes Olympus and through-the-scope esophageal/pyloric dilating balloons Boston Scientific and Balton with variable diameters from 6 to 12 mm.

Results:

Surgical resection of the antral-pyloric region was performed to one child because her parents wanted. The other five children were successfully applied EBD. Patients underwent 1 – 10 dilating sessions (mean 4.8/patient). Estimated antrum diameter prior to dilation ranged from 2 mm to 6 mm (mean 3.0). Following dilation, diameter of the antrum increased to 10 to 12 mm (mean 11.0) at final endoscopy. In patients requiring a single dilating session (n = 1), predilation antrum size was 6 mm, which increased to of 10 mm. In patients requiring multiple dilating sessions (n = 4), pre-dilation antrum size was a mean of 2.25 mm (range 2 – 3 mm), which increased to a mean of 11.25 mm (range 10 – 12 mm). All patients had good long-term response, with follow-up of 2 – 62 months (mean 27.4). To get sustainable results in maintaining patency of the gastric outlet is necessary to conduct a series of repeated EBD, the amount of which depends on the individual characteristics of the child.

Conclusions:

Endoscopic balloon dilatation is an effective method of restoring patency output of the stomach, which avoids surgery. It can be recommended as a method of choice for children with partial GOO caused by after ulcerous stenosis.