Radiology, Vol 178, 475-479, Copyright © 1991 by Radiological Society of North America
Rectal strictures: treatment with fluoroscopically guided balloon dilation
EE de Lange and HA Shaffer Jr
Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908.
The authors performed 25 fluoroscopically guided balloon dilation
procedures in nine patients with rectal strictures. In all cases, the
stricture developed after rectal surgery. Four patients underwent ileoanal
anastomosis after total colectomy for various conditions; five patients
underwent rectosigmoid end-to-end anastomosis after resection of a tumor or
as treatment for diverticulitis. Maximal stricture dilatation was attained
in 20 instances with a single 15-30-mm balloon. In five procedures, two
balloons (20 or 15 mm) were inflated simultaneously ("kissing balloons"
technique) to dilate the strictures. In five patients, only one dilation
procedure was required for effective treatment of the strictures, with no
clinical evidence of strictures after follow-up of 1.5-56 months (mean,
29.5 months). In the other four patients, multiple procedures were
performed: nine in one patient, five in one patient, and three in two
patients. In these patients, no recurrent symptoms developed during
follow-up of 1.25-18 months (mean, 8.1 months) after the last dilation.
Complicating leaks, infection, or hemorrhage did not occur after any of the
procedures. Fluoroscopically guided balloon dilation is a safe and
effective procedure for the treatment of rectal strictures.
