Interventional Treatment for Gastrointestinal Tract

Do, Young Soo

Abstract

Percutaneous gastrostomy, ballon dilatation, and metallic stent placement are the most common interventional procedures in radiology for the GI tract. Percutaneous gastrostomy provides nutritional support for patients with a debilitating disease or major swallowing difficulty. The most common candidates are patients with cerebral vascular accidents. Percutaneous gastrostomy is associated with a lower morbidity than surgically or endoscopically placed gastrostomy catheters and is also less expensive. Benign strictures of the GI tract are generally treated by balloon dilatation. Very tight strictures usually require stepwise dilation, beginning with a small balloon and gradually increasing the balloon diameter. Balloon dilatation is technically successful in more than 90% of patients, and functional success is achieved in 86âˆ¼90%. Metallic stents are used to manage strictures or obstructions in the esophagus and GI tract. For the esophagus, stent placement has been used effectively in the treatment of malignant dysphagia and is now a well-established procedure. The technical success rate approaches 100% and improvements in the dysphagia score ranges from 83% to 100%. From the successful use in the esophagus, stents have been employed in the stomach, duodenum, and colon. Metallic stents are currently an estalished component of the nonsurgical management of gastroduodenal and colorectal obstructions. Metallic stents within the stomach, duodenum, or colon are used for nonsurgical palliation of the symptoms of gastric or colonic obstruction rather than as a curative procedure. This palliation is intended to improve the quality of life in patients with an unresectable disease or used as an interin procedure prior to a definitive surgical management.