Colonoscopic hydrostatic balloon dilatation of Crohn's strictures

Recurrent strictures cause considerable morbidity among many patients with Crohn's disease. We present a retrospective review of the outcome of patien ts who underwent endoscopic hydrostatic balloon dilatation of Crohn's stric tures in our hospital over the past 7 years. All patients were under observ ation at Addenbrooke's Hospital, Cambridge. An initial assessment of all st rictures was made radiologically, and any patient with active disease was t reated before consideration of endoscopic dilatation. Dilatation was carrie d out with Microvasive Rigiflex balloons. Outcome after dilatation was asse ssed by review at subsequent clinic visits. Sixteen of 22 patients had reso lution of their obstructive symptoms after dilatation, although one third o f patients required more than two dilatations over the follow-up period. Si x of 22 patients had persisting symptoms after endoscopic treatment, requir ing surgery. There were no complications noted after any of the 71 dilatati ons that were performed. We conclude that hydrostatic balloon dilatation is a safe and effective alternative to surgery in the management of Crohn's s trictures within the reach of the colonoscope.