Balloon dilatation in esophageal strictures in epidermolysis bullosa and the role of anesthesia

Title

Balloon dilatation in esophageal strictures in epidermolysis bullosa and the role of anesthesia

Creator

Gollu G; Ergun E; Ates U; Can O S; Dindar H

Identifier

Publisher

Diseases of the Esophagus

Date

2017

Subject

adolescent; dysphagia; retrospective study; priority journal; school child; preschool child; clinical effectiveness; patient safety; human; article; child; female; male; adult; clinical article; young adult; colon interposition; gastrostomy; anesthesia; balloon dilatation; epidermolysis bullosa; esophagus stenosis/co [Complication]; esophagus stenosis/th [Therapy]; digestive endoscope; esophagus balloon; esophagus perforation; feeding difficulties; surgical intervention; endoscopic balloon dilatation

Description

Esophageal involvement, which causes stricture, is a complication in epidermolysis bullosa. This causes dysphagia and malnutrition and leads to deterioration of skin lesions in these patients. The charts of 11 patients with epidermolysis bullosa and esophageal stricture who were included into dilatation program between 2003 and 2015 were retrospectively reviewed. Seven of the patients were female and four were male. The median age was 14 (2-32) years. The mean body weight of patients was 27.8 (9-51) kg. The location and number of strictured parts of the esophagus were previously evaluated with upper gastrointestinal contrast study and after that flexible endoscopy was used for dilatation. Eight patients had middle esophageal, three patients had proximal esophageal and one of them had both proximal and middle esophageal strictures. The strictures were dilated 56 times in total (mean 5 times). One patient underwent gastrostomy and was medically followed-up after a perforation occurrence during the dilatation procedure. In a 32-year-old female patient, colon interposition was performed after four dilatations since optimal nutritional and developmental status could not be achieved. The dilatation program of nine patients is still in progress. Seven of them can easily swallow solid food but two of them have some difficulties in swallowing between dilatations. One patient rejected the program and quitted, while one patient refused colon interposition and died because of complications related to amyloidosis during the dilatation program. After resolution of the swallowing problem, skin lesions were observed to heal quickly. Epidermolysis bullosa is a rare cause of dysphagia. Esophageal balloon dilatation with flexible endoscopy is a safe and efficient method in patients with this condition.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Citation

Gollu G; Ergun E; Ates U; Can O S; Dindar H, “Balloon dilatation in esophageal strictures in epidermolysis bullosa and the role of anesthesia,” Pediatric Palliative Care Library, accessed December 8, 2021, https://pedpalascnetlibrary.omeka.net/items/show/16669.

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