Korean J Radiol.  2008 Aug;9(4):364-370. 10.3348/kjr.2008.9.4.364.

Fluoroscopically Guided Balloon Dilation for Benign Anastomotic Stricture in the Upper Gastrointestinal Tract

• Kim JH
• Shin JH
• Song HY

• KMID: 1076463
• DOI: http://doi.org/10.3348/kjr.2008.9.4.364

Abstract

A benign anastomotic stricture is a common complication of upper gastrointestinal (UGI) surgery and is difficult to manage conservatively. Fluoroscopically guided balloon dilation has a number of advantages and is a safe and effective procedure for the treatment of various benign anastomotic strictures in the UGI tract.

Keyword

Gastrointestinal tract, interventional procedures; Stomach, interventional procedures; Esophagus, interventional procedures; Stomach, stenosis or obstruction; Esophagus, stenosis or obstruction

MeSH Terms

*Anastomosis, Surgical
Balloon Dilatation/adverse effects/*methods
Constriction, Pathologic/etiology/therapy
Esophagus/*surgery
Fluoroscopy
Humans
Postoperative Complications
Stomach/*surgery

Figure

• 

  Fig. 1 Fluoroscopically guided balloon dilation for anastomotic stricture at gastroduodenostomy. A. UGI series before balloon dilation shows anastomotic stricture (arrow) at gastroduodenostomy. B-E. Anastomotic stricture is initially dilated using 15-mm-diameter balloon. As dilation is easily accomplished, caliber of balloon catheter is increased to 20 mm. F, G. UGI series immediately (F) and one month after (G) balloon dilation showed improvement of luminal diameter (arrows).

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  Fig. 2 Fluoroscopically guided balloon dilation for anastomotic stricture at gastrojejunostomy. A. UGI series before balloon dilation shows severe anastomotic stricture (arrow) at gastrojejunostomy with no passage of contrast medium. B, C. 20-mm-diameter balloon is placed and is inflated until waist forms by stricture disappeared. D. One month after balloon dilation, anastomotic stricture is greatly improved (arrows).

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  Fig. 3 Fluoroscopically guided balloon dilation for anastomotic stricture at esophagojejunostomy. A. UGI series before balloon dilation shows severe anastomotic stricture (arrow) at esophagojejunostomy. B, C. 20-mm-diameter balloon is placed and is inflated until waist forms by stricture disappeared. D. Immediately after balloon dilation, stricture is greatly improved (arrow).

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  Fig. 4 Fluoroscopically guided balloon dilation for anastomotic stricture after Ivor-Lewis surgery. A. UGI series before balloon dilation shows anastomotic stricture (arrow) at esophagogastrostomy. B, C. 20-mm-diameter balloon is placed and is inflated until waist forms by stricture disappeared. D. Immediately after balloon dilation, stricture is greatly improved (arrow).

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  Fig. 5 Intramural rupture of anastomosis (type 1 rupture) after fluoroscopically guided balloon dilation for anastomotic stricture after Ivor-Lewis surgery. UGI series obtained immediately after balloon dilation (A) shows small amount of contrast leakage (arrow). One-month follow-up UGI series (B) shows healed intramural tear.

Reference

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