- Title
- Occurrence of and risk factors for complications after endoscopic dilation in eosinophilic esophagitis
- Creator
- Jung, Kee Wook; Gundersen, Nancy; Smyrk, Thomas C.; Alexander, Jeffrey A.; Kopacova, Jana; Arora, Amindra S.; Romero, Yvonne; Katzka, David; Francis, Dawn; Schreiber, Julie; Dierkhising, Ross A.; Talley, Nicholas J.
- Relation
- Gastrointestinal Endoscopy Vol. 73, Issue 1, p. 15-21
- Publisher Link
- http://dx.doi.org/10.1016/j.gie.2010.09.036
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2011
- Description
- Background: Several small series have suggested an increased risk of complications associated with esophageal dilation in patients with eosinophilic esophagitis (EoE). Objective: To quantitate the risk and identify risk factors for esophageal complications in dilation in EoE patients. Design: Retrospective, uncontrolled, single-center study. Setting: Tertiary referral hospital. Patients: A total of 161 EoE patients (mean ± standard deviation age 44.3 ± 15.3 years, 112 men, 49 women, 150 white patients, 10 unknown, 1 Asian). Interventions: Through-the-scope balloon or Savary dilation of EoE. Main Outcome Measurements: The rate of complications defined as deep mucosal tear, major bleeding, or perforation, and determination of risk factors for complications. Results: A total of 293 dilations were performed in 161 patients. Complications reported were deep mucosal tear in 9.2% (n = 27), major bleeding in 0.3% (n = 1), and immediate perforation in 1.0% (n = 3). All patients with perforations were successfully treated medically without surgery (mean ± standard deviation hospital stay 5.3 ± 3.2 days). Factors associated with an increased risk of complications were luminal narrowing in the upper (odds ratio [OR], 5.62; 95% CI, 2.07-15.26; P < .001) and middle third of the esophagus (OR, 4.93; 95% CI, 1.64-14.83; P < .005) compared with lower third, luminal stricture unable to be traversed with a standard upper endoscope (OR, 2.48; 95% CI, 1.06-5.83; P = .037), and use of Savary dilator (OR, 2.63; 95% CI, 1.18-5.83; P = .018). Limitations: Retrospective design, uncontrolled study. Conclusions: Deep mucosal tears are common after dilation (9%), but the risk of immediate transluminal perforation with EoE is approximately 1%. The risk of severe complications is increased in patients with more proximal stricture and strictures that initially prevent endoscope passage.
- Subject
- endoscopic dilation; eosinophilic esophagitis; deep mucosal tears; risk factors for complications
- Identifier
- http://hdl.handle.net/1959.13/936692
- Identifier
- uon:12380
- Identifier
- ISSN:0016-5107
- Language
- eng
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