| Theme |
Endoscopic balloon dilation for small bowel stricture in Crohn's disease |
| Title |
Endoscopic balloon dilatation using single-balloon endoscopy |
| Author |
Kazuo Ohtsuka |
Department of Endoscopy, University Hospital of Medicine, Tokyo Medical and Dental University |
| Author |
Kento Takenaka |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Eiko Saito |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Shuji Hibiya |
Department of Endoscopy, University Hospital of Medicine, Tokyo Medical and Dental University |
| Author |
Ami Kawamoto |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Toshimitsu Fujii |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Masakazu Nagahori |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Noriyuki Ogata |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Mamoru Watanabe |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| [ Summary ] |
EBD has made it possible to postpone or avoid surgery for stenosis in CD. Two types of single-balloon endoscopes (SBEs), SIF-Q260 and SIF-H290S, are available. SIF-Q260 has a 2000 mm working length and a 2.8 mm inner channel diameter, and SIF-H290S has a 1520 mm working length and a 3.2 mm inner channel diameter. They are selected based on the location of the lesions. Narrow band imaging can be used to facilitate the diagnosis of the presence of an ulcer at the stenosis site. The hood of the endoscope is useful but it has the problem of lengthening at the bending section. The contrast agent is important for evaluating stenosis. With SBE, the contents of the intestinal tract can easily backflow outward. Therefore, it is recommended to inject a lubricating gel into the overtube and to cover the proximal tips of the overtube with moistened gauze in order to prevent backflow. To avoid blind procedures for mild stenosis, the dilator is inserted through the channel after passing the scope through the stenosis; when pulling the scope out, the dilator is brought to the stenosis and dilated. EBD by SBE is useful in endoscopic treatment. |