Treatment of Rectal Stricture with Crohn's Disease Using Local Steroid Injection Following Dilation by Bougienation / 대한소화기내시경학회지

Crohn's disease has shown increased frequency in Korea. When unresponsive to medical therapy, intestinal stricture, a serious complication of Crohn's disease, sometimes requires surgical resection. However, surgical therapy has many problems because the stricture tend to recur frequently. Recently, endoscopic therapy such as bougienation or balloon dilatation has been used in treatment of intestinal stricture, because of its inexpensiveness, simplicity and safety. Combined steroid injection therapy using has shown more effective outcome than endoscopic dilatation alone by suppression of wound healing and reduction of fibrosis. We report a case of complicated rectal stricture in a patient with Crohn's disease, which dilated successfully using injection of triamcinolone following bougienation.

A Case of Syndrome of Inappropriate Antidiuretic Hormone Secretion and Pneumomediastinum Complicated by Bougienation in Malignant Esophageal Stricture / 대한소화기내시경학회지

Bougienation is generally an effective method providing temporary relief of obstruction to facilitate stent insertion in patients with malignant esophageal stricture. The complicated by after bougienation such as esophageal perforation, mediastinitis, bronchoesophageal fistula, pneumomediastinum, pneumothorax were reported. However, syndrome of inappropriate antidiuretic hormone secretion (SIADH) complicated by bougienation has rarely been reported. Thus, we report a case of SIADH and pneumomediastinum complicated by bougienation in a patient with malignant esophageal stricture.

Airway Management by Bougienation in Tracheal Stenosis: A case report / 대한마취과학회지

The incidence of tracheal stenosis is increased because of the longterm respiratory care with endotracheal intubation and tracheostomy. Present therapeutic modalities for the relief of an tracheal or bronchial stenosis include laser resection, radiotherapy, cryotherapy, bougienation, stent insertion, dilatation with balloon catheter and finally reconstruction surgery. However, reconstruction surgery have some problems in ventilation during anesthetic management. Small sized tube insertion through lesion, high frequency jet ventilation, cardiopulmonary bypass are served to resolve ventilatory problem. We experienced a case of severe tracheal stenosis due to tracheostomy. The stenotic lesion was 2.5 cm above the carina, 3 mm in diameter and length of the stenotic segment was 1 cm. We used bougienation with endotracheal tube replace obturator for the ventilation before the reconstruction surgery and the patient was successfully managed without complications.