Management of NSAID-related pyloric obstruction in a child using endoscopic balloon dilatation: A case report

Abstract

Öztan MO, Güngör-Takeş G, Çağan-Appak Y, Yıldız C, Karakoyun M, Baran M. Management of NSAID-related pyloric obstruction in a child using endoscopic balloon dilatation: A case report. Turk J Pediatr 2018; 60: 765-768.A gastric outlet obstruction (GOO) is a major complication of peptic ulcers (PUs) and corrosive ingestion in children; however, the optimal management of a patient with a GOO after a PU remains controversial. Although surgical correction is the most common treatment option, endoscopic balloon dilatation and simultaneous dilatation with a steroid injection are used more frequently as first-line treatments for PU-related GOOs. These patients require operative interventions when the obstruction cannot be managed using endoscopic approaches or in cases of relapsing after the procedure. Here, we present a case to create awareness that endoscopic balloon dilatation is a simple, effective, and safe therapy for a PU-related GOO.

Pyloric stenosis secondary to peptic ulcer disease in pediatric patients: A case report and review of the literature

“…[ 28 ] Therefore, it has been recommended that endoscopic pyloric balloon dilatation be attempted before surgery in children with ulcerative scarred pyloric obstruction, [ 29 ] especially in children with peptic ulcers induced by NSAID medication use. [ 30 ] However, studies have also shown that the long-term success of endoscopic therapy for ulcerative incisional pyloric stenosis in adolescent patients is questionable. One case reported a failed attempt at endoscopic balloon dilatation.…”

Gastric outlet obstruction in a patient with relapsed medulloblastoma on metronomic therapy

“…As demonstrated in this case, pyloric stenosis can be readily diagnosed and effectively managed by endoscopic approaches even in pediatric patients. 11,12 In all, we highlight an uncommon but serious adverse effect of gastric outlet obstruction, potentially associated with celecoxib as part of metronomic therapy delivered for relapsed medulloblastoma. Gastrointestinal toxicities should be systematically evaluated in these protocols.…”

Tratamiento endoscópico de la obstrucción del tracto de salida gástrico de origen péptico-cicatricial en un niño de 4 años

“…Se han utilizado técnicas endoscópicas complementarias para aumentar la eficacia de la DEB en las estenosis benignas refractarias, incluidas, entre otras, la inyección de esteroides locales intralesionales como la triamcinolona 5,6 y la incisión endoscópica con electrocauterización. 7,8 Se presenta un paciente pediátrico con una estenosis prepilórica secundaria a enfermedad ulceropéptica, sin respuesta al tratamiento médico, que requirió dilataciones progresivas neumáticas y la combinación con otras técnicas endoscópicas, como la inyección de triamcinolona e incisiones con electrocauterio.…”