Update on endoscopic management of gastric outlet obstruction in children

• 作者: Hsun-Chin Chao
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Gastric OUTLET OBSTRUCTION Endoscopic BALLOON DILATATION Electrocauterization STEROID injection CHILDREN
• 年，卷（期）: 2016,（18）
• 页码范围: 635-645
• 页数: 11页
• 分类号: R

摘要

Endoscopic balloon dilatation (EBD) and surgical intervention are two most common and effective treattreatments for gastric outlet obstruction. Correction of gastric outlet obstruction without the need for surgery is an issue that has been tried to be resolved in these decades; this management has developed with EBD,advanced treatments like local steroid injection, electrocauterization,and stent have been added recently.The most common causes of pediatric gastric outlet obstruction are idiopathic hypertrophic pyloric stenosis,peptic ulcer disease followed by the ingestion of caustic substances, stenosis secondary to surgical anastomosis;antral web, duplication cyst, ectopic pancreas, and other rare conditions. A complete clinical, radiological and endoscopic evaluation of the patient is required to make the diagnosis, with complimentary histopathologic studies. EBD are used in exceptional cases, some with advantages over surgical intervention depending on each patient in particular and on the characteristics and etiology of the gastric outlet obstruction. Local steroid injection and electrocauterization can augment the effect of EBD. The future of endoscopic treatment seems to be aimed at the use of endoscopic electrocauterization and balloon dilatations.