BSPGHAN 2021 Virtual Annual Meeting

27- 29 April 2021

SINGLE CENTRE EXPERIENCE OF ENDOSCOPIC BALLOON DILATATION FOR LUMINAL STRICTURES IN PAEDIATRIC PATIENTS WITH CROHN’S DISEASE

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Eleni Volonaki
Eleni Volonaki
3 months ago

You have shown that 16 out of 21 patients with IBD-related strictures did not have surgery and/or had symptom improvement after one or two EBD. Would you say that these patients would have had an operation otherwise? What happened to one third of the patients without symptom improvement following EBD? What were the circumstances of the patient that had 6 EBDs so far? Thank you.

Kirn Sandhu
Kirn Sandhu
3 months ago
Reply to  Eleni Volonaki

Yes definitely some of them would have avoided surgery. A few patients were referred from other centers as patient/family did not want surgery.
The patients who did not have symptom improvement following EBD: 4 of them underwent surgery and 2 had further dilatations.
The patient with 6 dilatations required multiple dilatations initially to open up the ileal stricture. She has been followed up almost 5 years since first dilatation and has avoided surgery and transitioned to adults.

Jutta Koeglmeier
Jutta Koeglmeier
2 months ago

2 patients in your series underwent surgery following the first dilatation, whilst 9 were re-dilated and 10 had no further dilatation. Could you comment how patients were chosen to undergo surgery or re-dilatation after the first one ?

Kirn Sandhu
Kirn Sandhu
2 months ago

The two patients who underwent surgery after first dilatation- 1st patient perforated post dilatation and underwent surgery, second patient was significantly symptomatic (obstructive symptoms and unable to eat solids) and the endoscopist was unable to pass scope after dilatation and proceeded to surgery.
For the 9 re-dilatations majority of them had a further dilatation as the endoscopist was not adequately able to dilate stricture on first dilatation. A maximum of 3 dilatations are performed during a single endoscopy session.