Huma Arshad Cheema.
Endoscopic balloon dilatation of Esophageal strictures in children.
Ann King Edward Med Uni Jan ;12(4):574-5.

Background: Esophageal Strictures in our country are commonly due to caustic ingestion. Other causes include strictures which are congenital, follow esophageal reflux disease and following sclerotherapy for varices. The aim of this prospective study was to assess the causes of benign esophageal strictures in pediatric patients and evaluate the safety and efficacy of endoscopically guided balloon dilatation (EBD) in their management. Setting and duration: This observational prospective study was carried out at the Department of Pediatric Gastroenterology, Children`s Hospital Lahore from Oct 2004 —Dec. 2006. Patients and methods: All patients in whom diagnosis of Benign Esophageal Strictures was confirmed by barium meal were included. Mode of management was endoscopically guided balloon dilatation (EBD). All dilatations were performed under general anesthesia, with airway protection. All procedures were done as outpatients. Results: A total of 29 children and adolescents aged between one year and 16 years (median = 6 years) were included in the study. There were 19 males and 10 females. Corrosive intake was the commonest cause of the stricture. These patients were submitted to a total of 74 dilatations), with a range of 1 to 6 sessions/patient. (mean = 2.6 sessions; median = 2 sessions). No patients had complications secondary to the procedure. Dilatations were successful in 27/29 (93.1%) patients and remaining 2 patients were referred for surgery. Conclusion: This study shows that the endoscopic balloon dilatation of esophageal strictures is efficacious and safe with low rates of complications. Only an occasional patient needs to be referred for surgery. Since accidental corrosive intake is the commonest cause of the stricture, there is urgent need for health education of mothers and other caregivers in this country.

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