Rectal strictures: treatment with fluoroscopically guided balloon dilation

Article Abstract:

Narrowing (stricture) of the rectum is a common side effect of surgery, radiation therapy, and can also be a sign of disease of the rectum. Most patients with strictures do not require treatment, but sometimes the narrowing becomes too severe, and treatment is needed. The common treatment involves surgery, which can cause inflammation and scar tissue. Fluoroscopically guided balloon dilation has been proposed as a possible treatment for this problem. It involves inserting a balloon into the narrowed passage and inflating the balloon to open the passage. The insertion of the balloon is aided using a fluoroscope to guide the balloon to the correct position. This study examined using this technique to treat rectal strictures in nine patients who had severe rectal strictures resulting from rectal surgery. Five of the patients required only one treatment and had no recurrence of the problem upon follow-up. In the other four patients, multiple procedures were performed, with nine being performed on one patient who had an ileostomy (an opening made in the small intestine for the elimination of its contents outside the body). After it was closed, only one dilation was needed. No severe or moderate side effects resulted from the treatment. Balloon dilation is an easy, safe, and effective treatment for rectal strictures. However, the long-term effectiveness of the treatment needs to be established. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Usage, Colorectal diseases, Intestinal diseases, Balloon dilatation, Diagnosis, Fluoroscopic, Fluoroscopic diagnosis

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Retained intrahepatic stones: treatment with piezoelectric lithotripsy combined with stone extraction

Article Abstract:

Hepatic (liver) duct stones are difficult to treat. Surgery is often unsuccessful in completely removing the stones. Basket extraction is a nonsurgical technique often used to remove the residual stones. This technique is problematic if the residual stones are large. Extracorporeal shock wave lithotripsy (ESWL) is a new nonsurgical technique using shock waves to dissolve stones in the bile ducts. Most research using ESWL has focused on stones located elsewhere than in the liver. No data has been produced on the use of piezoelectric lithotripsy, which uses electric current produced by crystals, in treating hepatic stones. Eleven patients with hepatic stones that either could not be removed surgically or would probably have caused problems underwent ESWL to facilitate nonsurgical removal of the stones in conjunction with basket extraction. Successful fragmentation of the stones was achieved in 6 of the 11 patients such that the stones could be removed without surgery. Partial success was seen in another 3 of the 11 patients. The reasons ESWL was not successful or only partially in some of the patients was attributed to difficulty in targeting the stones and to the deformity of the ducts. The results indicate that piezoelectric lithotripsy can be clinically useful to breakup residual hepatic stones so that they can be removed nonsurgically. (Consumer Summary produced by Reliance Medical Information, Inc.)

Innovations, Evaluation, Lithotripsy

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Update on therapy for hepatobiliary diseases

Article Abstract:

There appears to have been significant progress in the identification and treatment of liver and gallbladder diseases. Currently available surgical and nonsurgical interventions include interferon alpha treatment, liver transplantation, gallbladder removal, and dissolving or crushing gallstones. Several of these procedures can be performed externally or through small tubes placed either into a small surgical cut or snaked through the digestive tract. Highlights of disease characteristics of hepatitis A, B, C, D, and E are presented.

Gallbladder diseases

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