P0759 COMPLICATIONS OF OESOPHAGEAL DILATATIONS

Abstract

Introduction: It is widely accepted that the initial treatment of oesophageal strictures due to ingestion of caustic substances should be based on dilatation. The most frequent complications could be: bleeding, a slight increase in body temperature, thoracic or abdominal pain, pneumomediastinum, oesophageal perforation and gastro-oesophageal reflux. Methods: The aim of the present study was to compare retrospectively the complications rate of oesophageal dilatations for caustic strictures in children in two different periods: 1988–94 and 1995–2002. From 1988 to 2002 we carried out 324 oesophageal dilatations under general anaesthetic in 50 patients following oesophageal caustication. Results: See table 1. The most frequent complication was bleeding; indeed, it is more reasonable to view this response as an unavoidable consequence of the procedure. The thoracic or abdominal pain is generally a sign of minor lesion of the oesophageal wall. Asymptomatic pneumomediastinun indicate perforation, that could be microscopic. Major complications are uncommon. The most serious is oesophageal perforation, the prognosis is generally good. This patients have a tendency to display gastro-oesophageal reflux (due to effects such as oesophageal shortening), and this may be aggravated by the frequent passage of dilators through the cardiac orifice.Table 1Conclusion: We have not found significant statistic differences between the two periods of study. Both methods of dilatation are effective and well tolerated. Oesophageal dilatation is the most common therapeutic alternative in the management of oesophageal strictures, the method is highly effective and well tolerated with a lower complications rate.