Endoscopic Balloon Dilation for Ileal Stricture in Crohn's Disease

Abstract

Therapeutic balloon dilation was performed colonoscopically, using a balloon dilatation catheter, on a patient who had a stricture of the terminal ileum resulting from Crohn's disease. The patient was a 53-year-old man who had undergone 4 abdominal operations for Crohn's disease between 1990 and 1995. He had been treated with medical and nutritional therapy, and had obtained symptomatic relief. The patient consulted our hospital complaining of lower abdominal pain and loss of appetite, and was admitted with a diagnosis of ileus on August 5, 2000. Contrast study of the small intestine showed a 6-cm-long stenosis of the terminal ileum. Conservative therapy for 2 months did not relieve the symptoms. Endoscopic treatment was considered preferable to surgery because the patient's multiple resections in the past increased the risk of short bowel syndrome. Balloon dilation was performed 3 times using a commercially available balloon dilatation catheter (CRE, Boston Scientific) , and sustained improvement was observed during a 9-month follow-up period. The present authors believe that endoscopic balloon dilation is a safe and effective therapeutic option for patients with intestinal strictures resulting from Crohn's disease, which has a high rate of symptomatic recurrence and re-operation.