Nealon W H, Beauchamp R D, Halpert R, Thompson J C
Department of Surgery, University of Texas Medical Branch, Galveston 77550.
Surgery. 1989 Jan;105(1):113-6.
Dilatation of esophageal strictures has been practiced for many years. More recently, balloon dilatation, with endoscopic guidance, has been applied to the stomach and the colon. The small bowel has been less accessible to the endoscope, and, as far as we have been able to determine, balloon dilatation of jejunal strictures has not been reported. We present a patient who was referred to us after curative resection of two abdomino-pelvic malignancies, external beam irradiation to the abdomen and pelvis, and multiple later operations for bowel obstruction and dehiscence of intestinal anastomoses. The bowel obstruction and anastomotic dehiscence occurred during the present hospitalization and resulted finally in the development of a high-output proximal jejunal fistula. The area of stricture, as seen by means of barium contrast, had two separate components with an associated acute angulation. We report the combined use of endoscopic and fluoroscopic manipulation and balloon dilatation of this complex stricture.
食管狭窄扩张术已应用多年。最近，在内镜引导下的球囊扩张术已应用于胃和结肠。小肠较难通过内镜触及，据我们所知，空肠狭窄的球囊扩张术尚未见报道。我们报告一位患者，其在根治性切除两处腹盆腔恶性肿瘤、腹部和盆腔外照射以及多次因肠梗阻和肠吻合口裂开而进行的后续手术后来我院就诊。肠梗阻和吻合口裂开发生在本次住院期间，最终导致高流量的近端空肠瘘形成。通过钡剂造影所见，狭窄区域有两个独立部分，并伴有急性成角。我们报告了对这种复杂狭窄联合使用内镜和荧光镜操作及球囊扩张术的情况。
