Clin Endosc.  2020 Jan;53(1):101-105. 10.5946/ce.2019.015.

Double-Balloon Endoscopy-Assisted Balloon Dilation of Strictures Secondary to Small-Intestinal Lymphoma

• Magome S
• Sakamoto H
• Shinozaki
• Okada M
• Yano T
• Sunada K
• Lefor AK
• Yamamoto H

• KMID: 2500913
• DOI: http://doi.org/10.5946/ce.2019.015

Figure

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  Fig. 1. Flowchart of the study. EBD, endoscopic balloon dilation.

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  Fig. 2. Endoscopic images of 5 cases before and after initial double-balloon endoscopy (DBE)-assisted endoscopic balloon dilation (EBD). (A) Patient 1 has a 2-mm stricture due to follicular lymphoma before an initial DBE-assisted EBD. (B) Patient 1: after an initial DBE-assisted EBD. (C) Patient 2 has a 4-mm stricture due to marginal zone lymphoma before an initial DBE-assisted EBD. (D) Patient 2: after an initial DBE-assisted EBD. (E) Patient 3 has a 4-mm stricture due to follicular lymphoma before an initial DBE-assisted EBD. The mucosa was edematous. (F) Patient 3: after an initial DBE-assisted EBD. (G) Patient 4 has a 6-mm stricture due to diffuse large B-cell lymphoma before an initial DBE-assisted EBD. (H) Patient 4: after an initial DBE-assisted EBD. (I) Patient 5 has a 9-mm stricture due to follicular lymphoma before an initial DBE-assisted EBD. (J) Patient 5: after an initial DBE-assisted EBD.

Reference

1. Chen Y, Chen Y, Chen S, et al. Primary gastrointestinal lymphoma: a retrospective multicenter clinical study of 415 cases in Chinese province of Guangdong and a systematic review containing 5075 Chinese patients. Medicine (Baltimore). 2015; 94:e2119.

2. Kobayashi H, Nagai T, Omine K, et al. Clinical outcome of non-surgical treatment for primary small intestinal lymphoma diagnosed with double-balloon endoscopy. Leuk Lymphoma. 2013; 54:731–736.

3. Coumaros D, Tsesmeli N, Tzilves D. Diffuse large B-cell lymphoma complicated with jejunal stricture: the palliative role of double-balloon enteroscopy. Am J Gastroenterol. 2008; 103:2656–2657.

4. Honzawa Y, Kondo M, Hayakumo T, Matsuura M, Nakase H. Successful endoscopic dilation treatment of small intestinal stricture occurring during chemotherapy for malignant lymphoma. Case Rep Gastroenterol. 2010; 4:323–329.

5. Tamura H, Ogata K, Kondo A, et al. [Double balloon endoscopy as a useful tool for the diagnosis and treatment of four cases of primary small intestinal lymphoma]. Rinsho Ketsueki. 2007; 48:510–513.

6. Sunada K, Shinozaki S, Nagayama M, et al. Long-term outcomes in patients with small intestinal strictures secondary to Crohn’s disease after double-balloon endoscopy-assisted balloon dilation. Inflamm Bowel Dis. 2016; 22:380–386.

7. Hirai F, Andoh A, Ueno F, et al. Efficacy of endoscopic balloon dilation for small bowel strictures in patients with Crohn’s disease: a nationwide, multi-centre, open-label, prospective cohort study. J Crohns Colitis. 2018; 12:394–401.

8. Cho E, Uno K, Tanaka K, Yasuda K, Nakajima M. A case with perforation after endoscopic balloon dilatation for stricture of malignant lymphoma. Dig Endosc. 2004; 16(Suppl 1):S73–S75.

9. Vaidya R, Habermann TM, Donohue JH, et al. Bowel perforation in intestinal lymphoma: incidence and clinical features. Ann Oncol. 2013; 24:2439–2443.