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Incidence and management of oesophageal ruptures following fluoroscopic balloon dilatation in children with benign strictures

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Abstract

Objectives

The purpose of this study is to investigate the incidence and management of oesophageal ruptures following fluoroscopic balloon dilatation (FBD) in children with benign oesophageal strictures.

Methods

Sixty-two children with benign oesophageal strictures underwent FBDs. Oesophageal rupture was categorized as intramural (type 1), transmural (type 2), or transmural with free leakage (type 3). The possible risk factors for oesophageal ruptures were analyzed.

Results

One hundred and twenty-nine FBDs were performed in these patients. The oesophageal rupture rate was 17.1 % (22/129). The majority (21/22) of ruptures were type 1 and type 2, both were treated conservatively. Only one patient had a type 3 rupture and underwent oesophagoesophagostomy. The patient gender, age, and the length and cause of the stricture showed no significant effect on the rupture (P > 0.05). However, for the patients ≤2 years old, the initial balloon with a diameter ≥10 mm showed a higher oesophageal rupture rate than those <10 mm during the first session (P = 0.03).

Conclusions

Although the oesophageal rupture rate in children was 17.1 %, the type 3 rupture rate was 0.8 %, which usually requires aggressive treatment. For children ≤2 years old, the initial balloon diameter should be <10 mm in the first session for decreasing the risk of oesophageal rupture.

Key Points

• The oesophageal rupture rate following balloon dilatation in children was 17.1 %.

• The incidence of transmural rupture with free leakage is very low.

• Only transmural rupture with free leakage needs aggressive treatment.

• For children ≤2 years, the initial balloon diameter should be <10 mm.

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Abbreviations

FBD:

Fluoroscopic balloon dilatation

OA:

Oesophageal atresia

TEF:

Tracheoesophageal fistula

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Acknowledgments

The scientific guarantor of this publication is Ho-Young Song. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding.

No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Wei-Zhong Zhou, Ho-Young Song, Jung-Hoon Park, Ji Hoon Shin, Jin Hyoung Kim, Young Chul Cho & Pyeong Hwa Kim

  2. Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China

    Wei-Zhong Zhou

  3. Pediatric Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Seong-Chul Kim

Authors
  1. Wei-Zhong Zhou
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  2. Ho-Young Song
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  3. Jung-Hoon Park
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  4. Ji Hoon Shin
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  5. Jin Hyoung Kim
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  7. Pyeong Hwa Kim
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  8. Seong-Chul Kim
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Correspondence to Ho-Young Song.

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Zhou, WZ., Song, HY., Park, JH. et al. Incidence and management of oesophageal ruptures following fluoroscopic balloon dilatation in children with benign strictures. Eur Radiol 27, 105–112 (2017). https://doi.org/10.1007/s00330-016-4342-2

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  • DOI: https://doi.org/10.1007/s00330-016-4342-2

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