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  • 1 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
  • 2 2nd Department of Medicine, Semmelweis University, Szentkirályi u. 46, H-1088, Budapest, Hungary
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Abstract

Intestinal stenosis is a frequent and oftentimes recurring problem in patients with Crohn's disease, accompanied by a high-risk for bowel resection and subsequent short bowel syndrome. Medical therapy has not proven successful, and even the most conservative surgical options are hampered by a definite mortality rate (and high recurrence rates) without doubt. Technical improvements in endoscopic devices over recent years have created an operative subspecialty (therapeutic endoscopy) that can be applied to several gastrointestinal diseases. Endoscopic balloon dilatation (EBD) for Crohn's disease has been developed to prevent or delay the need for surgical resection. The endoscopy-assisted dilatation is a safe and effective treatment modality for uncomplicated, short Crohn's strictures, and therefore should be offered to Crohn's disease patients. Here, we briefly review the current knowledge on hydrostatic balloon dilatation and present a relevant case from our clinical practice.

  • 1. L. Lakatos L.S. Kiss G. David 2011 Incidence, disease phenotype at diagnosis, and early disease course in inflammatory bowel diseases in Western Hungary, 2002–2006 Inflamm Bowel Dis 17 12 2558 2565.

    • Search Google Scholar
    • Export Citation
  • 2. I. Ind L. Riis T. Jess 2006 Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003–2005: a population-based study from the Danish Crohn colitis database Am J Gastroenterol 101 1274 1282.

    • Search Google Scholar
    • Export Citation
  • 3. C. Gasche J. Scholmerich J. Brynskov 2000 A simple classification of Crohn's disease: report of the Working Party for the World Congresses of Gastroenterology, Vienna 1998 Inflamm Bowel Dis 6 1 8 15.

    • Search Google Scholar
    • Export Citation
  • 4. E. Louis A. Collard A.F. Oger 2001 Behaviour of Crohn's disease according to the Vienna classification: changing pattern over the course of the disease Gut 49 777 782.

    • Search Google Scholar
    • Export Citation
  • 5. I.C. Solberg M.H. Vatn O. Hoie 2007 Clinical course in Crohn's disease: results of a Norwegian population-based ten-year followup study Clin Gastroenterol Hepatol 5 1430 1438.

    • Search Google Scholar
    • Export Citation
  • 6. R.A. Brower 1986 Hydrostatic balloon dilation of a terminal ileal stricture secondary to Crohn's disease Gastrointest Endosc 32 1 38 40.

    • Search Google Scholar
    • Export Citation
  • 7. A.G. Wibmer A.J. Kroesen J. Gröne 2010 Comparison of strictureplasty and endoscopic balloon dilatation for stricturing Crohn's disease — review of the literature Int J Colorectal Dis 25 10 1149 1157.

    • Search Google Scholar
    • Export Citation
  • 8. C. Hassan A. Zullo V. De Francesco 2007 Systematic review: endoscopic dilatation in Crohn's disease Aliment Pharmacol Ther 26 11—12 1457 1464.

    • Search Google Scholar
    • Export Citation
  • 9. C. Thienpont A. D'Hoore S. Vermeire 2010 Long-term outcome of endoscopic dilatation in patients with Crohn's disease is not affected by disease activity or medical therapy Gut 59 3 320 324.

    • Search Google Scholar
    • Export Citation
  • 10. G.W. Erkelens S.J. van Deventer 2004 Endoscopic treatment of strictures in Crohn's disease Best Pract Res Clin Gastroenterol 18 1 201 207.

    • Search Google Scholar
    • Export Citation
  • 11. G. Di Nardo S. Oliva M. Passariello 2010 Intralesional steroid injection after endoscopic balloon dilation in pediatric Crohn's disease with stricture: a prospective, randomized, double-blind, controlled trial Gastrointest Endosc 72 6 1201 1208.

    • Search Google Scholar
    • Export Citation
  • 12. V.V. Singh P. Draganov J. Valentine 2005 Efficacy and safety of endoscopic balloon dilation of symptomatic upper and lower gastrointestinal Crohn's disease strictures J Clin Gastroenterol 39 4 284 290.

    • Search Google Scholar
    • Export Citation
  • 13. J.E. East J.C. Brooker M.D. Rutter 2007 A pilot study of intrastricture steroid versus placebo injection after balloon dilatation of Crohn's strictures Clin Gastroenterol Hepatol 5 9 1065 1069.

    • Search Google Scholar
    • Export Citation
  • 14. A. Swaminath S. Lichtiger 2008 Dilation of colonic strictures by intralesional injection of infliximab in patients with Crohn's colitis Inflamm Bowel Dis 14 2 213 216.

    • Search Google Scholar
    • Export Citation
  • 15. F. Hirai T. Beppu S. Sou 2010 Endoscopic balloon dilatation using double-balloon endoscopy is a useful and safe treatment for small intestinal strictures in Crohn's disease Dig Endosc 22 3 200 204.

    • Search Google Scholar
    • Export Citation

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  • Medicine (miscellaneous) SJR Quartile Score (2018): Q3
  • Scimago Journal Rank (2018): 0.228
  • SJR Hirsch-Index (2018): 11

Language: English

Founded in 2008
Publication: One volume of four issues annually
Publication Programme: 2020. Vol. 12.

Publishing Model: Open Access with no author fee

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Senior editors

Editor(s)-in-Chief: Ágoston Szél

Vice Editor(s)-in-Chief: János Gál

Vice Editor(s)-in-Chief: Kálmán Hüttl

Vice Editor(s)-in-Chief: Béla Merkely

Chair of the Editorial Board: Balázs Hauser

Editorial Board

  • Miklós Antal (University of Debrecen, Hungary)
  • Enrico Calzia (Universitätsklinikum Ulm, Germany)
  • Zoltán Csanádi (University of Debrecen, Hungary)
  • Attila Doros (Semmelweis University, Hungary)
  • Edit Dósa (Semmelweis University, Hungary)
  • Dariusz Dudek (Jagiellonian University, Poland)
  • Susumu Eguchi (Nagasaki University, Japan)
  • László Entz (Semmelweis University, Hungary)
  • Nagy A. Habib (Imperial College London, UK)
  • Balázs Hauser (Semmelweis University, Hungary)
  • Miklós D. Kertai (Duke University, USA)
  • András Komócsi (University of Pécs, Hungary)
  • Karl-Heinz Kuck (Asklepios Klinik St. Georg, Germany)
  • Pal Maurovich-Horvat (Semmelweis University, Hungary)
  • Péter Metzger (Danube Hospital/SMZ-Ost, Austria)
  • László Miskolczi (University of Miami, USA)
  • Balázs Nemes (University of Debrecen, Hungary)
  • Attila Oláh (Petz Aladár County and Teaching Hospital, Hungary)
  • Wojciech G. Polak (Erasmus Medical Center, The Netherlands)
  • Robert Reisch (Clinic Hirslanden Zurich, Switzerland)
  • Bernhard Riedel (Vanderbilt University Medical Center, USA)
  • David Royston (Harefield Hospital, UK)
  • Thomas A. Sos (New York Presbyterian Hospital, USA)
  • Wolfgang Trubel (Privatklinik Doebling, Austria)

Semmelweis University. Institute of Human Morphology and Developmental Biology
Address: Tűzoltó u. 58. H-1094 Budapest, Hungary
E-mail: szel@ana2.sote.hu