Endoscopic hydrostatic balloon dilation of ulcer-induced pyloric stenosis in rheumatoid arthritis and secondary amyloidosis

Surg Endosc. 1997 Jun;11(6):673-5. doi: 10.1007/s004649900420.

Abstract

We describe a 50-year-old Japanese woman with rheumatoid arthritis who presented with near-complete gastric outlet obstruction. The patient also suffered from secondary gastrointestinal and cardiac amyloidosis. Gastroscopy revealed multiple huge gastric antral ulcers in which amyloid deposits were identified on histologic examination. The ulcers became scars after treatment with omeprazole, which cause in severe pyloric stenosis. Endoscopic hydrostatic balloon dilation under fluoroscopic guidance was performed twice for 10 min. The pyloric outlet remained sufficiently patent 22 months later.

Publication types

  • Case Reports

MeSH terms

  • Amyloidosis / complications*
  • Amyloidosis / drug therapy
  • Amyloidosis / pathology
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Anti-Ulcer Agents / therapeutic use
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / drug therapy
  • Biopsy
  • Cardiomyopathies / complications*
  • Cardiomyopathies / drug therapy
  • Cardiomyopathies / pathology
  • Catheterization / methods*
  • Female
  • Fluoroscopy
  • Gastroscopy / methods
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use
  • Humans
  • Hydrostatic Pressure
  • Middle Aged
  • Omeprazole / therapeutic use
  • Parenteral Nutrition, Total
  • Pyloric Stenosis / diagnosis
  • Pyloric Stenosis / etiology
  • Pyloric Stenosis / therapy*
  • Stomach Ulcer / chemically induced
  • Stomach Ulcer / diagnostic imaging
  • Stomach Ulcer / pathology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Anti-Ulcer Agents
  • Glucocorticoids
  • Omeprazole