Abstract
Background
Surgical correction is the most preferred treatment modality in pyloric stricture (PS). Recently a few studies reported the experience of balloon dilation in children with PS. This study was designed to present our experiences of the management of the patients with PS with balloon dilation and corrective surgery.
Methods
The records of 14 patients who were treated with the diagnosis of PS between August 2003 and August 2011 were reviewed retrospectively.
Results
There were nine boys and five girls (mean age, 3.4 ± 1.7 years). The history of caustic ingestion was detected in eight patients; six of them were admitted on the day of ingestion. Two patients were admitted with nonbilious vomiting more than 2 weeks after ingestion. Four patients did not have a remarkable medical history, including caustic ingestion. They admitted with the complaint of nonbilious vomiting. PS was detected during endoscopy in two patients who had a diagnosis of peptic ulcer disease. PS was shown by barium meal study in all patients. Endoscopy was performed in all patients. Endoscopic balloon dilation was tried in 12 patients. Overall eight patients required surgical procedures for PS. The complaints were resolved by endoscopic balloon dilation of pylorus in the remaining six patients.
Conclusions
Although endoscopic balloon dilatation for benign PS in adults is a generally accepted method of treatment, there is less experience with endoscopic balloon dilatation for PS in children. PS due to benign disorders can be effectively and successfully treated through endoscopic balloon dilatation in suitable patients. In patients with successful pyloric balloon dilatation, surgery can be avoided.
Similar content being viewed by others
References
Tekant G, Eroğlu E, Erdoğan E, Yeşildağ E, Emir H, Büyükünal C, Yeker D (2001) Corrosive injury-induced gastric outlet obstruction: a changing spectrum of agents and treatment. J Pediatr Surg 36:1004–1007
Treem WR, Long WR, Friedman D, Watkins JB (1987) Successful management of an acquired gastric outlet obstruction with endoscopy guided balloon dilatation. J Pediatr Gastroenterol Nutr 6(6):992–996
Sharma KK, Ranka P, Goyal P, Dabi DR (2008) Gastric outlet obstruction in children: an overview with report of Jodhpur disease and Sharma’s classification. J Pediatr Surg 43:1891–1897
Sharma KK, Agrawal P, Toshniwal H (1997) Acquired gastric outlet obstruction during infancy and childhood: a report of five unusual cases. J Pediatr Surg 32:928–930
Nazir Z, Arshad M (2005) Late-onset primary gastric outlet obstruction—an unusual cause of growth retardation. J Pediatr Surg 40:e13–e16
Lin JY, Lee ZF, Yen YC, Chang YT (2007) Pneumatic dilation in treatment of late-onset primary gastric outlet obstruction in childhood. J Pediatr Surg 42:e1–e4
Chan KL, Saing H (1994) Balloon catheter dilatation of peptic pyloric stenosis in children. J Pediatr Gastroenterol Nutr 18(4):465–468
Karnsakul W, Cannon ML, Gillespie S, Vaughan R (2010) Idiopathic non-hypertrophic pyloric stenosis in an infant successfully treated via endoscopic approach. World J Gastrointest Endosc 2(12):413–416
Ciftci AO, Senocak ME, Büyükpamukçu N, Hiçsönmez A (1999) Gastric outlet obstruction due to corrosive ingestion: incidence and outcome. Pediatr Surg Int 15:88–91
Özokutan BH, Ceylan H, Ertaşkin I, Yapici S (2010) Pediatric gastric outlet obstruction following corrosive ingestion. Pediatr Surg Int 26:615–618
Özcan C, Ergün O, Sen T, Mutaf O (2004) Gastric outlet obstruction secondary to acid ingestion in children. J Pediatr Surg 39:1651–1653
Hogan RB, Polter DE (1986) Nonsurgical management of lye-induced antral stricture with hydrostatic balloon dilatation. Gastrointest Endosc 32:228–230
Chaudhary A, Puri AS, Dhar P, Reddy P, Sachdev A, Lahoti D, Kumar N, Broor SL (1996) Elective surgery for corrosive-induced gastric injury. World J Surg 20:703–706
Kaushik R, Singh R, Sharma R, Attri AK, Bawa AS (2003) Corrosive-induced gastric outlet obstruction. Yonsei Med J 44:991–994
Snyder JD, Rosenblum N, Wershil B, Goldman H, Winter HS (1987) Pyloric stenosis and eosinophilic gastroenteritis in infants. J Pediatr Gastroenterol Nutr 6(4):543–547
Chaudhary R, Shrivastava RK, Mukhopadhyay HG, Diwan RN, Das AK (2001) Eosinophilic gastritis—an unusual cause of gastric outlet obstruction. Indian J Gastroenterol 20(3):110
Colon AR, Sorkin LF, Stern WR, Lessinger VS, Hefter LG, Hodin E (1983) Eosinophilic gastroenteritis. J Pediatr Gastroenterol Nutr 2(1):187–189
Kochhar R, Sethy PK, Nagi B, Wig JD (2004) Endoscopic balloon dilatation of benign gastric outlet obstruction. J Gastroenterol Hepatol 19:418–422
DiSario JA, Fennerty MB, Tietze CC, Hutson WR, Burt RW (1994) Endoscopic balloon dilation for ulcer-induced gastric outlet obstruction. Am J Gastroenterol 89:868–871
Kuwada SK, Alexander GL (1995) Long-term outcome of endoscopic dilation of nonmalignant pyloric stenosis. Gastrointest Endosc 41:15–17
Heymans HAS, Bartelsman JWFM, Herweijer TJ (1988) Endoscopic balloon dilatation as treatment of gastric outlet obstruction in infancy and childhood. J Pediatr Surg 23(2):139–140
Nasr A, Ein SH, Connolly B (2008) Recurrent pyloric stenosis: to dilate or operate? A preliminary report. J Pediatr Surg 43:E17–E20
Jawaid W, Abdalwahab A, Blair G, Skarsgard E, Webber E (2006) Outcomes of pyloroplasty and pyloric dilatation in children diagnosed with nonobstructive delayed gastric emptying. J Pediatr Surg 41:2059–2061
Disclosures
Drs. Abdulkerim Temiz, Pelin Oguzkurt, Semire Serin Ezer, Emine Ince, Hasan Ozkan Gezer, and Akgun Hicsonmez have no conflicts of interest or financial ties to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Temiz, A., Oguzkurt, P., Ezer, S.S. et al. Management of pyloric stricture in children: endoscopic balloon dilatation and surgery. Surg Endosc 26, 1903–1908 (2012). https://doi.org/10.1007/s00464-011-2124-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-011-2124-0