Colonoscopic balloon dilation of Crohn's strictures: a review of long-term outcomes

Eur J Gastroenterol Hepatol. 2003 May;15(5):485-8. doi: 10.1097/01.meg.0000059110.41030.bc.


Objective: To study the long-term outcomes of patients who have had endoscopic balloon dilation of Crohn's strictures.

Design: Retrospective case-note review over a 16-year period.

Patients: Patients with a Crohn's stricture causing obstructive symptoms and who had at least 6 months' follow-up data or a surgical outcome following dilation were sought; 59 patients (124 dilations) were identified.

Intervention: Patients all underwent endoscopic balloon dilation.

Results: Strictures were anastomotic in 53 patients (111 dilations) and de novo in six patients (13 dilations). The median stricture length was 3.0 cm. Median follow-up time was 29.4 months. Out of the total group, 41% of patients achieved long-term clinical benefit following dilation and in 17% after only a single dilation. The median number of dilations per patient was one. A total of 35 (59%) patients required surgery for their stricture during follow-up. There were two (1.6%) perforations as a result of dilation, one in an anastomotic stricture (managed conservatively) and one in a de-novo stricture (requiring surgery). There were no deaths.

Conclusions: Colonoscopic balloon dilation of Crohn's strictures can achieve long-term clinical benefit in many patients. Repeat dilations are justified in initial non-responders. In this series, the procedure appears safe with low morbidity.

MeSH terms

  • Adult
  • Aged
  • Catheterization / methods*
  • Colonoscopy*
  • Crohn Disease / complications*
  • Follow-Up Studies
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / pathology
  • Intestinal Obstruction / therapy*
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome