Background: Image-guided balloon dilatation has been used in adults as an alternative to standard
surgical treatment of intestinal stricture. The experience in children is limited. We report our results
with this procedure in the management of both congenital and acquired intestinal stenosis in
children.
Materials and Methods: A retrospective analysis was done of children younger than 2 years of age
who underwent balloon dilatation of small and large intestinal stenosis between 1994 and 2003.
Results: Eleven children underwent dilatation during the study period. Two of these children had
congenital duodenal stenosis, and this represents the first report of nonoperative management of
this condition. Three children underwent dilatation of small bowel strictures and 6 had dilatation
of colonic and rectal strictures. Necrotizing enterocolitis was the most common (6/9) etiology of stricture.
Ten of 11 patients did not require subsequent operative management although 3 children required
further dilatations. The mean follow-up was 36.5 months (range, 13 days–103 months). One
patient underwent a subsequent dilatation that was unsuccessful, and required operative resection
of a 5-cm stricture. There was one complication, a small leak that was managed nonoperatively.
Conclusion: Image-guided balloon dilatation holds promise as an alternative to surgical treatment
in children with congenital or acquired stenosis of the small or large bowel, and should be considered
in select patients with short strictures.
