Crohn’s Stricture Dilatation

GUT 2010; 59: 320-324

P. Rutgeerts’ Leuven group have just released their outcome data from performing 237 stricture dilatations in 138 Crohn’s patients. This is the largest series to-date with the longest follow-up (5.8 years)

Immediate success was seen in 97%, with 46% requiring a repeat dilatation after a mean time of 12.5 months. In the long term surgery was still required in 24%, however, 76% avoided surgery and its associated morbidity and mortality rates. Serious adverse events did occur with thenedoscopic dilatation in 5.1% of cases (6/237 perforations, 5/237 GI bleeds and 1/237 acute abdominal pain requiring hospitalisation).

The procedures were performed with Boston Scientific water filled Rigiflex balloons (8cm long, 18mm diameter). A multistep inflation protocol was used (2 minutes at 15 – 16.5 – 18mm) and repeated if neccessary. Patients were observed for 1 hour after. In general this proved to be a very safe technique and the efficacy of endoscopic dilatation was felt to outweigh the complication risk.