Endoscopic balloon dilation of postoperative duodenal stricture by using a new type of wire‐guided balloon catheter

Abstract

When the stricture of gastrointestinal tract is complicated, the insertion of the balloon catheter is very difficult even with ‘through‐the‐scope’ balloon dilators. We present here a new type of multifunctional balloon dilator, controlled radial expansion (CRE) wire‐guided balloon dilatation catheter (Boston Scientific, MA, USA). This instrument enabled successful treatment of a complicated postoperative stricture of the duodenum. A 74‐year‐old man, who had undergone duodenum‐preserving resection of the head of the pancreas for mucin‐producing tumor, had severe stenosis at the duodenal second portion. After failed trials in negotiating the stricture by means of conventional balloon dilators, CRE wire‐guided balloon dilatation catheter was introduced through the working channel of the scope and advanced over a guide wire into the stricture under fluoroscopic control. The stenosis was successfully dilated up to the full size of the balloon (20 mm) by increasing the inflation pressure in a stepwise manner. After the procedure, the patient could consume soft food and gruel easily without complications. The dilation effect has been maintained up to the present for more than 12 months. This new instrument is recommended in endoscopic dilation as a safe and useful tool, even for a complicated stricture.