Esophageal stenosis in epidermolysis bullosum:a challenge for the endoscopist

Angelis, Paola De; Caldaro, Tamara; Torroni, Filippo; Romeo, Erminia; Foschia, Francesca; Abriola, Giovanni Federici di; Rea, Francesca; Hachem, May El; Genovese, Elisabetta; D'Alessandro, Sandra M.; Dall’Oglio, Luigi

doi:10.1016/j.jpedsurg.2011.02.017

Cited by 24 publications

(15 citation statements)

References 23 publications

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“…It is directly related to squamous cell carcinoma which is the most common cause of death in patients with EB. 4,7 In this study, there was only one complication among 56 dilatations, which was esophageal perforation during an EBD session in an 11-year-old male patient. Gastrostomy was performed, enteral feeding was stopped and broad-spectrum parenteral antibiotics were initiated.…”

Section: Discussionmentioning

confidence: 60%

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Balloon dilatation in esophageal strictures in epidermolysis bullosa and the role of anesthesia

Göllü

Ergün

Ateş

et al. 2016

Diseases of the Esophagus

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Esophageal involvement, which causes stricture, is a complication in epidermolysis bullosa. This causes dysphagia and malnutrition and leads to deterioration of skin lesions in these patients. The charts of 11 patients with epidermolysis bullosa and esophageal stricture who were included into dilatation program between 2003 and 2015 were retrospectively reviewed. Seven of the patients were female and four were male. The median age was 14 (2-32) years. The mean body weight of patients was 27.8 (9-51) kg. The location and number of strictured parts of the esophagus were previously evaluated with upper gastrointestinal contrast study and after that flexible endoscopy was used for dilatation. Eight patients had middle esophageal, three patients had proximal esophageal and one of them had both proximal and middle esophageal strictures. The strictures were dilated 56 times in total (mean 5 times). One patient underwent gastrostomy and was medically followed-up after a perforation occurrence during the dilatation procedure. In a 32-year-old female patient, colon interposition was performed after four dilatations since optimal nutritional and developmental status could not be achieved. The dilatation program of nine patients is still in progress. Seven of them can easily swallow solid food but two of them have some difficulties in swallowing between dilatations. One patient rejected the program and quitted, while one patient refused colon interposition and died because of complications related to amyloidosis during the dilatation program. After resolution of the swallowing problem, skin lesions were observed to heal quickly. Epidermolysis bullosa is a rare cause of dysphagia. Esophageal balloon dilatation with flexible endoscopy is a safe and efficient method in patients with this condition.

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Section: Discussionmentioning

confidence: 60%

“…3 Esophageal bullae formation is caused by the trauma of solid, hot or poorly masticated foods. 4 Blister formation in the oropharynx and/or esophagus causes symptoms of dysphagia. Also after blister formation and chronical ulcer inflammation, esophageal strictures subsequently give way to mechanical obstruction.…”

Section: Introductionmentioning

confidence: 99%

Balloon dilatation in esophageal strictures in epidermolysis bullosa and the role of anesthesia

Göllü

Ergün

Ateş

et al. 2016

Diseases of the Esophagus

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“…Вероятно, это связано с редкостью самого заболевания [16]. Однако, полу-ченные результаты говорят о преимуществах баллон-ной дилатации в сравнении с остальными методиками ввиду простоты исполнения, безопасности, эффектив-ности и низкого риска возникновения осложнений [25]. В течение последних двух десятилетий в лечении сте-нозов пищевода различной этиологии баллонная дила-тация заменила инвазивные методы лечения и стала методом выбора [18].…”

Section: лечениеunclassified

Balloon Dilatation of Esophageal Strictures in Children With Bullous Epidermolysis: Description of Case Series

Tupylenko¹,

Лохматов²,

Мурашкин³

et al. 2017

Pediatr. farmakol.

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Esophageal strictures are the most common complications of bullous epidermolysis in children. Strictures cause the development of dysphagia that prevents oral alimentation and receipt of an adequate amount of nutrients that is accompanied by a violation of nutritional status, weight loss, and delayed physical development of a child. Disturbed swallowing can also cause aspiration syndrome, pneumonia, and airway obstruction. To eliminate dysphagia and reduce the risk of complications, it is necessary to restore esophageal patency. The article describes the results of X-ray with assisted balloon dilatation in 19 children with bullous epidermolysis and dysphagia. It is shown that this method of esophagus recanalization allows to effectively and safely restore oral alimentation of children already in the first day after intervention with a gradual expansion of the diet.

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“…Balloon dilation of esophageal strictures is the standard of care for patients with EB-related strictures and can improve dysphagia and oral intake. (16) However, symptom improvement is frequently transient, necessitating repetitive esophageal dilations over time. Although balloon dilation has been described in patients with EB, and recommended techniques developed, the risks associated with esophageal dilation and the recurrence rates of stricture formation have not been systematically studied.…”

Section: Introductionmentioning

confidence: 99%

Approach and Safety of Esophageal Dilation for Treatment of Strictures in Children With Epidermolysis Bullosa

Anderson¹,

Feinstein²,

Krämer

et al. 2018

J. pediatr. gastroenterol. nutr.

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Esophageal stenosis in epidermolysis bullosum:a challenge for the endoscopist

Cited by 24 publications

References 23 publications

Balloon dilatation in esophageal strictures in epidermolysis bullosa and the role of anesthesia

Balloon dilatation in esophageal strictures in epidermolysis bullosa and the role of anesthesia

Balloon Dilatation of Esophageal Strictures in Children With Bullous Epidermolysis: Description of Case Series

Approach and Safety of Esophageal Dilation for Treatment of Strictures in Children With Epidermolysis Bullosa

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