Dilation of Pediatric Eosinophilic Esophagitis - Adverse Events and Short Term Outcomes.

Objectives: Although several studies report the experience with adult eosinophilic esophagitis (EoE) related stricture, outcomes for pediatric patients with EoE associated fibrostenosis and stricture is even more limited. To address this, we aim to identify the adverse event rate and short-term outcomes of the largest reported cohort of children with EoE to undergo esophageal dilation for management of symptomatic esophageal narrowing. Methods: A retrospective assessment of all children, 18 years and younger, who underwent esophageal dilation at an academic children's hospital over a 5-year period was conducted. Clinical, endoscopic, histologic and outcomes of dilation were extracted from the medical record. Adverse events (AE) were captured within a standardized endoscopic adverse event database. Grade 2 AE (requiring unanticipated medical intervention) were termed significant. Dilation related events were compared between patients with EoE, without EoE and those undergoing standard upper endoscopy. Results: Of 451 total dilations, 68 dilations were performed in 40 EoE patients (mean age 13.8 years, SD 3.3 yrs [4.6-18.9 yrs]). Forty-three percent (17/40) had repeat dilation during the study period. Dilation related grade 2 AE rates in EoE and in non-EoE patients were 2.9% and 3.1%, respectively (p > 0.5). Chest pain (any grade AE) was reported in 14.7% of EoE dilations. No significant associations were found between post procedural pain and dilation method, final dilator size, medical therapy or esophageal eosinophilia. No perforations or significant hemorrhage were reported. Conclusions: We conclude dilation can be performed safely in children with EoE. In the appropriate clinical setting, cautious dilation may be considered in the management of fibrostenotic EoE. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2acUpoN
via IFTTT