Department of Pediatric Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
Surg Endosc. 2012 Jul;26(7):1903-8. doi: 10.1007/s00464-011-2124-0. Epub 2012 Jan 11.
Surgical correction is the most preferred treatment modality in pyloric stricture (PS). Recently a few studies reported the experience of balloon dilation in children with PS. This study was designed to present our experiences of the management of the patients with PS with balloon dilation and corrective surgery.
The records of 14 patients who were treated with the diagnosis of PS between August 2003 and August 2011 were reviewed retrospectively.
There were nine boys and five girls (mean age, 3.4 ± 1.7 years). The history of caustic ingestion was detected in eight patients; six of them were admitted on the day of ingestion. Two patients were admitted with nonbilious vomiting more than 2 weeks after ingestion. Four patients did not have a remarkable medical history, including caustic ingestion. They admitted with the complaint of nonbilious vomiting. PS was detected during endoscopy in two patients who had a diagnosis of peptic ulcer disease. PS was shown by barium meal study in all patients. Endoscopy was performed in all patients. Endoscopic balloon dilation was tried in 12 patients. Overall eight patients required surgical procedures for PS. The complaints were resolved by endoscopic balloon dilation of pylorus in the remaining six patients.
Although endoscopic balloon dilatation for benign PS in adults is a generally accepted method of treatment, there is less experience with endoscopic balloon dilatation for PS in children. PS due to benign disorders can be effectively and successfully treated through endoscopic balloon dilatation in suitable patients. In patients with successful pyloric balloon dilatation, surgery can be avoided.
外科矫正术是治疗幽门狭窄（PS）的首选方法。最近有几项研究报道了儿童 PS 患者使用球囊扩张的经验。本研究旨在介绍我们使用球囊扩张和矫正手术治疗 PS 患者的经验。
回顾性分析 2003 年 8 月至 2011 年 8 月期间诊断为 PS 的 14 例患者的病历。
男 9 例，女 5 例（平均年龄 3.4±1.7 岁）。8 例患者有腐蚀性摄入史；其中 6 例在摄入当天入院。2 例在摄入后 2 周以上出现无胆汁性呕吐而入院。4 例患者无明显病史，包括腐蚀性摄入。他们因非胆汁性呕吐而就诊。2 例有消化性溃疡病诊断的患者在胃镜检查中发现 PS；所有患者均经钡餐检查显示 PS。所有患者均行内镜检查。12 例患者尝试行内镜球囊扩张。8 例患者因 PS 需要手术。其余 6 例患者通过幽门内镜球囊扩张缓解了症状。
尽管成人良性 PS 的内镜球囊扩张是一种被普遍接受的治疗方法，但儿童 PS 的内镜球囊扩张经验较少。通过内镜球囊扩张可有效、成功地治疗良性病变引起的 PS。在成功进行幽门球囊扩张的患者中，可以避免手术。
