Aneurysm ; Dilatation ; Humans ; Postoperative Complications ; Tracheostomy ; Tracheotomy/adverse effects*

Endoscopic papillary balloon dilation (EBD) for choledocholithiasis is known to be comparable to endoscopic sphincterotomy (EST) especially in cases of small stones. With larger stones, EBD with conventional balloon, which have a diameter of 6-8 mm, was reported as less effective for extraction of stones. We evaluated the efficacy and complications of EBD with large balloons (10-15 mm) after limited EST for retrieval of choledocholithiasis. From February 2005, we have performed EBD with limited EST for retrieval of common bile duct (CBD) stones. The patients who admitted with hyperamylasemia and gallstone pancreatitis were excluded. In cases without CBD dilation, EPBD with 12 mm for 40 seconds was performed. And in cases with CBD dilation, we dilated the sphincters with 15 mm sized balloon for 40 seconds. Total 22 patients (11 of male) were performed EBD with limited EST for retrieval of CBD stones. The median diameter of the stones was 10 mm (5-25 mm). Ten cases had multiple stones and 6 cases periampullary diverticuli. Successful stone removal in the initial session of ERCP with EBD was accomplished in 16 patients (72.7%). And complete retrieval of bile duct stones was achieved in all patients with repeated ERCP. In the aspect of complications, any episodes of perforation, bleeding was not developed. Only one case of mild grade of post-procedural pancreatitis was noted. However, post-procedural hyperamylasemia was developed in 16 cases (68.2%). EBD with larger balloon seems to be a feasible and safe alternative technique for conventional EST in CBD stone extraction.
Treatment Outcome ; *Sphincterotomy, Endoscopic/adverse effects ; Male ; Humans ; Female ; Choledocholithiasis/surgery/*therapy ; *Balloon Dilatation/adverse effects ; Aged

Aneurysm, Dissecting ; classification ; surgery ; Aortic Aneurysm ; etiology ; Dilatation, Pathologic ; Humans ; Stents ; adverse effects

Massive postpartum haemorrhage after Cesarean section for placenta previa is a common occurrence. The bleeding is usually from the placental bed at the lower uterine segment. Uterine tamponade has a role in the management of such patients especially when fertility is desired. We describe here a case of massive postpartum haemorrhage, which was managed, with the use of a Sengstaken-Blakemore tube. This allowed us to avoid a hysterectomy for a young primiparous patient.
Balloon Dilatation/*instrumentation ; Cesarean Section/adverse effects ; Postpartum Hemorrhage/etiology ; Postpartum Hemorrhage/*therapy

OBJECTIVETo investigate the risk factors of vaginal dilators by 567 adverse event reports, and to provide a reference for the reasonable use.

METHODSWith retrospective case study, analyzed 567 reports induced by vaginal dilators by National Adverse Drug Reaction Monitoring Center in 2012.

RESULTSExpected treatment of disease might be relevant with severity of adverse events, while age was not the related factor; the influencing factor of consequences of grading was the classification of the cause of adverse events.

CONCLUSIONMonitoring should be strengthen in order to reduce or avoid the vaginal dilator adverse events.

Adverse Drug Reaction Reporting Systems ; Dilatation ; adverse effects ; Drug-Related Side Effects and Adverse Reactions ; epidemiology ; Female ; Humans ; Retrospective Studies ; Risk Factors ; Vagina ; pathology

BACKGROUND/AIMS: The aim of this study was to evaluate the outcome of endoscopic dilation for benign anastomotic stricture after radical gastrectomy in gastric cancer patients. METHODS: Gastric cancer patients who underwent endoscopic balloon dilation for benign anastomosis stricture after radical gastrectomy during a 6-year period were reviewed retrospectively. RESULTS: Twenty-one patients developed benign strictures at the site of anastomosis. The majority of strictures occurred within 1 year after surgery (95.2%). The median duration to stenosis after surgery was 1.70 months (range, 0.17 to 23.97 months). The success rate of the first endoscopic dilation was 61.9%. Between the restenosis group (n=8) and the no restenosis group (n=13), there were no significant differences in the body mass index (22.82 kg/m2 vs 22.46 kg/m2), interval to symptom onset (73.9 days vs 109.3 days), interval to treatment (84.6 days vs 115.6 days), maximal balloon diameter (14.12 mm vs 15.62 mm), number of balloon dilation sessions (1.75 vs 1.31), location of gastric cancer or type of surgery. One patient required surgery because of stricture refractory to repeated dilation. CONCLUSIONS: Endoscopic dilation is a highly effective treatment for benign anastomotic strictures after radical gastrectomy for gastric cancer and should be considered a primary intervention prior to proceeding with surgical revision.
Anastomosis, Surgical/adverse effects ; Constriction, Pathologic/etiology/therapy ; Dilatation/*methods ; Female ; Gastrectomy/*adverse effects ; Gastroscopy/*methods ; Humans ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Stomach Neoplasms/*surgery ; Treatment Outcome

PURPOSE: This study was undertaken to evaluate the long-term treatment of esophageal strictures in children with corrosive esophagitis and to determine the effect of self-bougienage on recurrent strictures. MATERIALS AND METHODS: We reviewed the medical records of nine children that were treated for corrosive esophageal strictures from May 2000 to May 2008. Six males and three females were included and their average age was 30 months. Six patients had ingested acids, two patents had ingested alkali, and one ingested an unknown agent. RESULTS: The interval between caustic ingestion and esophageal stricture ranged from one to eight weeks. The average length of the esophageal strictures was 3.8 cm (range, 1 to 9.2 cm). Four patients had a long segment stricture (longer than 5 cm) and one patient had multiple strictures. The most common site of involvement was the upper third followed by the mid third of the esophagus. Eight patients received repeated dilatation using a balloon catheter or bougie dilator. Among the eight patients, two patients had complete resolution of symptoms and six patients required surgery. Among five patients that developed restenosis of the esophageal anastomosis site, three patients had improved symptoms after self-bougienage and two patients had improved symptoms with repeated balloon dilatation or endoscopic bougienage. There were no complications in these patients. CONCLUSION: Although a small number of patients were studied, self-bougienage was safe, less invasive, and effective for the management of esophageal restenosis in patients who required frequent dilation after surgery.
Adult ; Aged ; Balloon Dilatation/adverse effects ; Esophageal Stenosis/*therapy ; Female ; Humans ; Male ; Middle Aged ; Self Care/*instrumentation ; Young Adult

A benign anastomotic stricture is a common complication of upper gastrointestinal (UGI) surgery and is difficult to manage conservatively. Fluoroscopically guided balloon dilation has a number of advantages and is a safe and effective procedure for the treatment of various benign anastomotic strictures in the UGI tract.
*Anastomosis, Surgical ; Balloon Dilatation/adverse effects/*methods ; Constriction, Pathologic/etiology/therapy ; Esophagus/*surgery ; Fluoroscopy ; Humans ; Postoperative Complications ; Stomach/*surgery

BACKGROUND/AIMS: Endoscopic papillary balloon dilation (EPBD) is a safe and effective method for the treatment of choledocholithiasis, but previous studies have rarely reported the appropriate ballooning time (BT). We prospectively evaluated the safety and efficacy of EPBD according to BT in patients undergoing bile duct stone removal. METHODS: Seventy consecutive patients with bile duct stones were randomly assigned to receive EPBD with either conventional (n = 35, 60 seconds) or short (n = 35, 20 seconds) BT. RESULTS: EPBD alone achieved complete bile duct clearance in 67 patients (long BT, n = 33, 94.3%; short BT, n = 34, 97.1%; p = 0.808). We also found no significant difference in the rate of complete duct clearance, including procedures that used mechanical lithotripsy, between the long and short BT groups (97.1% vs. 100%; p = 0.811). Mild pancreatitis was noted in four (11.4%) patients in the long BT group and two (5.7%) patients in the short BT group, but this incidence was not significantly different. CONCLUSIONS: The study showed that EPBD using both 20-sec and 60-sec BTs is safe and effective for the treatment of bile duct stones. Short and long BTs produced comparable outcomes.
Aged ; Aged, 80 and over ; Balloon Dilatation/adverse effects/*methods ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis/radiography/*therapy ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Time Factors ; Treatment Outcome

OBJECTIVE: We wanted to present the results of percutaneous management of ureteral injuries that were diagnosed late after cesarean sections (CS). MATERIALS AND METHODS: Twenty-two cases with 24 ureteral injuries that were diagnosed late after CS underwent percutaneous nephrostomy (PN), antegrade double J (DJ) catheter placement and balloon dilatation or a combination of these. The time for making the diagnosis was 21 +/- 50.1 days. The injury site was the distal ureter in all cases (the left ureter: 13, the right ureter: 7 and bilateral: 2). Fifteen complete ureteral obstructions were detected in 13 cases. Ureteral leakage due to partial (n = 4) or complete (n = 3) rupture was noted in seven cases. Two cases had ureterovaginal fistula. All the cases were initially confirmed with antegrade pyelography and afterwards they underwent percutaneous nephrostomy. Balloon dilatation was needed in three cases. Antegrade DJ stents were placed in 10 cases, including the three cases with balloon dilatation. Repetititon of percutaneous nephrostomy with balloon dilatation and DJ stent placement was needed in one case with complete obstruction. All the cases were followed-up with US in their first week and then monthly thereafter for up to two years. RESULTS: Eighteen ureters (75%) were managed by percutaneous procedures alone. A total of six ureter injuries had to undergo surgery (25%). CONCLUSION: Percutaneous management is a good alternative for the treatment of post-CS ureteral injuries that are diagnosed late after CS. Percutaneous management is at least preparatory for a quarter of the cases where surgery is unavoidable.
Adult ; Balloon Dilatation ; Cesarean Section/*adverse effects ; Female ; Humans ; Nephrostomy, Percutaneous ; Pregnancy ; Rupture ; Stents ; Time Factors ; Ureter/*injuries/surgery ; Ureteral Obstruction/diagnosis/etiology