Abstract
Whereas gastric outlet obstruction (GOO) in adults is commonly caused by peptic ulcer disease,in infancy and childhood hypertrophic pyloric stenosis is the most frequent cause. Pyloromyotomy is the generally accepted treatment. When after this procudure vomiting persists beyond a period of 3 weeks, inadequate myotomy and eventually reoperation should be considered. Balloon dilatation (BD) in infants and children has only been described as treatment of achalasia of the esophagus, we describe the first successful experience with BD of the pylorus in 3 children with GOO. In 2 the obstruction was caused by inadequate pyloromyotomy, in 1 by damage to N.vagus. During endoscopy after exclusion of peptic abnormalities, a flexible quide wire was passed through the pylorus. A balloon dilatator (Lunderquist-Owman PVED 14, max diameter 15 mm) was introduced over the guide wire and across the pylorus under fluorescopic control. The balloon was inflated max. with in water diluted gastrographin and kept in place for 1 minut. Following deflation of the ballon, the dilatator and guide wire were removed simultaniously. All 3 patients remained free of symptoms during follow-up for more than 1 year. Ramstadt procedure remains the treatment of first choice in hypertrophic pylorusstenosis. BD can offer a good alternative to reoperation in those cases in which GOO persists.
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Heymans, H., Bartelsman, J. 79. ENDOSCOPIC BALLOON DILATATION AS TREATMENT OF GASTRIC OUTLET OBSTRUCTION IN INFANCY AND CHILDHOOD. Pediatr Res 22, 109 (1987). https://doi.org/10.1203/00006450-198707000-00100
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DOI: https://doi.org/10.1203/00006450-198707000-00100