ABSTRACT
Self-expanding metal stents are an established treatment for malignant colon strictures, either as palliative treatment or as a bridge to later surgery. Little data exist regarding the use of stents for benign obstructions and the rate of subsequent complications related to the procedure is high. After reviewing the existing literature, we found only one case of stent placement in an intestinal obstruction caused by endometriosis, as a bridge to surgery. The use of prostheses in benign disease has a higher rate of complications such as stent migration and gut perforation. Such complications are even more likely to happen when the stent has been placed as a bridge to surgery and it is delayed for more than 7 days. This is the case of a young woman presenting an acute intestinal obstruction related to endometrioma. Stent placement was used in this case as a bridge to surgery with successful results.
Subject(s)
Colectomy/methods , Colonic Diseases/diagnosis , Colonic Diseases/surgery , Intestinal Obstruction/diagnosis , Intestinal Obstruction/surgery , Stents , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Adult , Colonic Diseases/etiology , Emergency Service, Hospital , Endometriosis/complications , Endometriosis/diagnosis , Female , Follow-Up Studies , Humans , Intestinal Obstruction/etiology , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
BACKGROUND: The present study was conducted to determine the effectiveness of intralesional triamcinolone to improve the results of endoscopic dilation in esophageal strictures. METHODS: We treated 9 patients with complex strictures of different etiologies (2 postsurgery, 3 gastroesophageal reflux disease, and 4 caustic) with intralesional injections of triamcinolone followed by endoscopic dilations. Outcomes of triamcinolone-treated patients were compared with those of historical control. We injected triamcinolone before dilating the strictures. All the patients were followed up for 1 year. The interval between dilations, frequency of dilation, and refractory rates were calculated. RESULTS: There was no difference between the control group and the patients with steroids regarding baseline characteristics (age and sex distribution of patients and stricture etiologies, length, and location). The patients in the triamcinolone group had a bigger improvement of their dysphagia and had a lower refractority rate than the patients in control group, these differences being statistically significant. CONCLUSIONS: Intralesional triamcinolone presented a higher improvement of dysphagia and a lower refractority rate in patients with complex strictures with statistically significant differences.
