Disease States
Where in the GI tract can a stricture form?
Esophagus, Gastric (pylorus), Colon
Purple packaging is for:
Silver packaging is for:
Purple - esophagus
Silver - esophagus, pylorus, colon
Why use dilation?
Restore a patient's ability to eat and drink normally
Allow access for additional procedures
CRE balloons have ___ shoulders
Rounded
Name 2 causes of a colonic stricture:
IBD
Anastomotic
Colon Cancer
What are the two main differences between the purple and the silver packaging?
- Fixed wire/ wire guided
- 5.5 CM balloon vs 8 CM balloon
What are the two types of dilators?
Fixed-Diameter
Radial Expanding
What handle is used for CRE balloons? What else do you need with it?
Alliance handle & alliance syringe
What is the name of a pyloric stricture:
Gastric Outlet Obstruction
What are the TWO locations where you can find what pressure the balloon needs to be blown up to:
The packaging
The tag on the balloon
You should tell the physician when you feel ____
RESISTANCE!
What is waisting?
Where the stricture pushes in on the balloon.
Name 2 causes of a benign esophageal stricture:
Schatzki’s ring
Esophageal webs
Achalasia
Anastomotic
Peptic
Caustic
Radiation
What is the rule of 3?
In a single session, no more than three dilators of sequentially larger size should be passed once moderate or greater resistance is evident. Dilators passed with no or mild resistance do not count toward this total.
What are two considerations for dilation?
Diameter -- diameter of the stricture as well as the diameter that the dilation needs to achieve
Dilator characteristics
Location of the stricture
Relationships among inflation pressure, balloon size, severity of stricture and dilation force
Why is negative pressure so important?
It retracts any air from the balloon and the catheter! You don't have to squeeze the alliance handle the entire time - you can let go.
Name 2 causes of esophageal malignant strictures:
Adenocarcinoma or Squamous cell
GERD, Dysplasia, Barrett’s then Adeno
Smoking and Alcohol
What does CRE stand for?
Controlled Radial Expansion
What are two of the benefits of using a balloon for dilation?
You can endoscopically visualize the stricture
You don't have to remove the scope
You can go up 3 sizes with one device
What material are CRE balloons made out of?
PEBAX!