Gastroscopic treatment of membranous duodenal stenosis in infants and children: Report of 6 cases

Objective: To investigate the efficacy of gastroscopic treatment in the treatment of membranous duodenal stenosis. Methods: We performed a retrospective study of 6 patients with membranous duodenal stenosis, aging from 7 days to 37 months, who underwent gastroscopic balloon dilatation in a children's hospital between January 2012 and December 2013. All surgical procedures of balloon dilatation were performed under direct gastroscopic vision. The balloon dilators with diameter 8 mm and 10 mm for neonates and children aged over one month, respectively, were placed through the foramen of the membranous stenosis. The septum in the membranous stenosis was gradually extended by increasing diameter of the balloon dilator. The residual septum was removed by gastroscopic electrocauterization. Results: The membranous stenosis in duodenum of all children was successfully expanded by gastroscopic balloon dilatation, and only one case with residual septum received gastroscopic electrocauterization. No complications such as bleeding, intestinal perforation, etc., were observed. Postoperative radiography using iodine-based contrast media showed that the gastrointestinal tract was unobstructed. During a follow-up period ranging from 3 to 24 months, all patients ate normally without vomiting and abdominal distension and grew normally. Conclusion: Gastroscopic balloon dilatation is an effective method in the treatment of membranous duodenal stenosis in children. For the patients with residual septum, they can be cured by using gastroscopic electrocauterization. (C) 2015 Elsevier Inc. All rights reserved.