Innovative Endoscopic Management of a Duodenal Web Using Balloon Dilatation and a Gastrojejunal Tube in an Infant with Complex Esophageal Atresia
- 1 December 2022
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Laparoendoscopic & Advanced Surgical Techniques
- Vol. 32 (12), 1269-1271
- https://doi.org/10.1089/lap.2022.0240
Abstract
Introduction: Congenital partial duodenal obstruction (CPDO) is a rare type of intestinal obstruction, including webs and stenoses. Treatment has usually been operative by laparoscopy or laparotomy. Some have proposed endoscopic treatment due to a higher surgical risk in patients with CPDO. However, restenosis seems to be frequent after simple balloon dilatation. Material and Methods: We report on a patient with CPDO and complex esophageal atresia in whom we used a gastrojejunal tube to keep the lumen open after endoscopic balloon dilatation over a guidewire. Results: Follow-up endoscopy showed no evidence of restenosis. During the third endoscopy, the opening could be dilated to 15 mm without any complications and the gastrojejunal tube was removed. Since then, there were no clinical signs of obstruction, and no further endoscopic intervention was necessary. Discussion and Conclusion: Using a gastrojejunal tube after endoscopic balloon dilatation of a duodenal web may lower the risk of restenosis. This technique should be considered in patients with comorbidities and considerable surgical risk that have a gastrostomy in place.Keywords
This publication has 7 references indexed in Scilit:
- Use of trans-anastomotic tubes in congenital duodenal obstructionJournal of Pediatric Surgery, 2022
- Natural orifice endoluminal technique (NOEL) for the management of congenital duodenal membranesJournal of Pediatric Surgery, 2020
- A Review of the Immunomodulating Components of Maternal Breast Milk and Protection Against Necrotizing EnterocolitisNutrients, 2019
- Endoscopic Division of Duodenal Web Causing Near Obstruction in 2-Year-Old with Trisomy 21Journal of Laparoendoscopic & Advanced Surgical Techniques, 2016
- Congenital duodenal web: successful management with endoscopic dilatationEndoscopy International Open, 2016
- Gastroscopic treatment of membranous duodenal stenosis in infants and children: Report of 6 casesJournal of Pediatric Surgery, 2015
- Endoscopic Dilation and Partial Resection of a Duodenal Web in an InfantJournal of Pediatric Gastroenterology and Nutrition, 2009