Endoscopic Guided Dilations without Intralesional Corticosteroid Injections: Pediatric Crohn’s Patients Case Series

<b>Background and Clinical Significance:</b> The treatment for pediatric Crohn’s disease (CD) has shifted over the years from steroids and immunomodulators to biologics with the goal of histological and clinical remission. Endoscopic balloon dilation (EBD) has been utilized for stricturi...

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Main Authors: Leo Fawaz, Yousif Slim, Peter N. Freswick
Format: Article
Language:English
Published: MDPI AG 2024-09-01
Series:Reports
Subjects:
Online Access:https://www.mdpi.com/2571-841X/7/4/81
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author Leo Fawaz
Yousif Slim
Peter N. Freswick
author_facet Leo Fawaz
Yousif Slim
Peter N. Freswick
author_sort Leo Fawaz
collection DOAJ
description <b>Background and Clinical Significance:</b> The treatment for pediatric Crohn’s disease (CD) has shifted over the years from steroids and immunomodulators to biologics with the goal of histological and clinical remission. Endoscopic balloon dilation (EBD) has been utilized for stricturing disease, even in the pediatric population. EBD has been shown to be effective and minimally invasive, though historically, has been performed on patients with persistent mucosal inflammation. As such, intralesional corticosteroid (ILC) injections have been traditionally utilized during EBD. However, intralesional corticosteroid efficacy among pediatrics patients in deep endoscopic remission is unknown. <b>Case Presentation:</b> We report four patients that demonstrated at least initial successful dilations without intralesional steroid injections. <b>Conclusions:</b> The use of ILC injections during routine EBDs in pediatric patients should be further explored in randomized control trials.
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spelling doaj-art-914dd2315cbf46bbb04820dab9d0aa932025-08-20T02:56:51ZengMDPI AGReports2571-841X2024-09-01748110.3390/reports7040081Endoscopic Guided Dilations without Intralesional Corticosteroid Injections: Pediatric Crohn’s Patients Case SeriesLeo Fawaz0Yousif Slim1Peter N. Freswick2Pediatric Gastroenterology Fellowship—Children’s Hospital of Michigan, Detroit, MI 48201, USAFamily Medicine Residency—Wayne State University, Detroit, MI 48201, USADivision of Pediatric Gastroenterology—Helen DeVos Children’s Hospital, Grand Rapids, MI 49503, USA<b>Background and Clinical Significance:</b> The treatment for pediatric Crohn’s disease (CD) has shifted over the years from steroids and immunomodulators to biologics with the goal of histological and clinical remission. Endoscopic balloon dilation (EBD) has been utilized for stricturing disease, even in the pediatric population. EBD has been shown to be effective and minimally invasive, though historically, has been performed on patients with persistent mucosal inflammation. As such, intralesional corticosteroid (ILC) injections have been traditionally utilized during EBD. However, intralesional corticosteroid efficacy among pediatrics patients in deep endoscopic remission is unknown. <b>Case Presentation:</b> We report four patients that demonstrated at least initial successful dilations without intralesional steroid injections. <b>Conclusions:</b> The use of ILC injections during routine EBDs in pediatric patients should be further explored in randomized control trials.https://www.mdpi.com/2571-841X/7/4/81Crohn’sdilationsstrictures
spellingShingle Leo Fawaz
Yousif Slim
Peter N. Freswick
Endoscopic Guided Dilations without Intralesional Corticosteroid Injections: Pediatric Crohn’s Patients Case Series
Reports
Crohn’s
dilations
strictures
title Endoscopic Guided Dilations without Intralesional Corticosteroid Injections: Pediatric Crohn’s Patients Case Series
title_full Endoscopic Guided Dilations without Intralesional Corticosteroid Injections: Pediatric Crohn’s Patients Case Series
title_fullStr Endoscopic Guided Dilations without Intralesional Corticosteroid Injections: Pediatric Crohn’s Patients Case Series
title_full_unstemmed Endoscopic Guided Dilations without Intralesional Corticosteroid Injections: Pediatric Crohn’s Patients Case Series
title_short Endoscopic Guided Dilations without Intralesional Corticosteroid Injections: Pediatric Crohn’s Patients Case Series
title_sort endoscopic guided dilations without intralesional corticosteroid injections pediatric crohn s patients case series
topic Crohn’s
dilations
strictures
url https://www.mdpi.com/2571-841X/7/4/81
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AT yousifslim endoscopicguideddilationswithoutintralesionalcorticosteroidinjectionspediatriccrohnspatientscaseseries
AT peternfreswick endoscopicguideddilationswithoutintralesionalcorticosteroidinjectionspediatriccrohnspatientscaseseries