Résumé
Objective To study the efficiency of endoscope-guided Savary bougie dilatation ( ESBD ) for strictured duodenal ulcer. Methods Forty-five patients with strictured duodenal ulcer were treated with endoscope-guided Savary bougie dilatation. The items of investigation were; easiness of passing the endo-scope through the strictured portion of duodenum, resolving of their symptoms and the complications happened after dilatation. Results The symptoms remitted and endoscope was advanced to descending portion of the duodenum through the stricture in all of 45 patients. The follow up period ranged from 6 months to 36 months. The rates of symptomatic remission were 97. 8% (44/45 ) , 97. 8% (44/45 ) , 94. 4% (34/36) , 93.7%(30/32) , 91.7% (22/24) and 87.5% (14/16) , at 6,12,18,24,30 and 36 months respectively. Recurrence of symptoms in patients without therapy was significantly higher than those with therapy. Conclusion ESBD is a safe and efficient procedure in treating the strictured duodenal ulcer.
Résumé
In endoscopic clinical research studies of patients who take NSAIDs, 10% to 20% of patients develop gastric ulcers and 4% to 10% develop duodenal ulcers. Ulcers associated with chronic NSAIDs use are typically painless and are located in the prepyloric region of the stomach. These characteristics make NSAIDs potential causes of gastric outlet obstruction. There were multiple cases of single or multiple strictures that were found in the esophagus, small bowel and colon. Most of duodenal strictures were confined to bulbar area. Only one case of duodenal second portion diaphragmlike stricture was reported in association with acetylsalicylic acid. We experienced one case of chronic NSAIDs induced duodenal 2nd portion stricture in ankylosing spondylitis and rhemathoid arthritis patient and reported with a review of literature.