{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T02:24:07Z","timestamp":1768443847627,"version":"3.49.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T00:00:00Z","timestamp":1722384000000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background: Epidermolysis Bullosa (EB) stands as the prototype category of disorders featuring subepidermal fragility, characterized by skin blistering induced by minimal trauma. The gastrointestinal tract is a common site of extracutaneous injury. Esophageal stricture (ES) is one of the severe complications, with nearly 70% of patients experiencing ES within the initial 25\u00a0years of life. Case Report: We present a 11-year-old female child of dystrophic EB (DEB) who presented with dysphagia. Barium swallow showed a short segment proximal ES. We faced many challenges before endoscopy owing to difficult intravenous access, restricted mouth opening, multiple dental caries and low haemoglobin. Dental extraction under general anaesthesia and fibreoptic intubation with a smaller sized endotracheal tube guided over epidural catheter was done at another tertiary care institute. Child had severe bleeding due to airway manipulation. Management: At our centre endoscopy guided serial balloon dilation (BD) of ES was performed without intubation under total intravenous anaesthesia (TIVA) without any complications. The stricture was serially dilated under direct visualization till 12\u00a0mm in three sessions at three-weekly intervals using CRE (controlled radial expansion) fixed and wire-guided balloon dilators. During the first session 20\u00a0mg of triamcinolone acetate injection was also topically applied without mucosal invasion. No such further topical or submucosal applications were attempted due to risk of perforation. Conclusion: Endoscopy guided BD of ES is safe and effective in EB patients when done by experienced team.<\/jats:p>","DOI":"10.1093\/omcr\/omae079","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T02:07:21Z","timestamp":1722478041000},"source":"Crossref","is-referenced-by-count":2,"title":["Endoscopic balloon dilation of esophageal stricture in dystrophic epidermolysis bullosa patient: challenges faced and safety of procedure"],"prefix":"10.1093","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8373-6127","authenticated-orcid":false,"given":"Ruchi","family":"Mishra","sequence":"first","affiliation":[{"name":"Bai Jerbai Wadia Hospital for Children Department of Pediatric Gastroenterology and Hepatology, , Acharya Donde Marg, Mumbai, 400012, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivangi","family":"Tetarbe","sequence":"additional","affiliation":[{"name":"Bai Jerbai Wadia Hospital for Children Department of Pediatric Gastroenterology and Hepatology, , Acharya Donde Marg, Mumbai, 400012, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinit Vinod","family":"Bedekar","sequence":"additional","affiliation":[{"name":"Bai Jerbai Wadia Hospital for Children Department of Anesthesiology, , Acharya Donde Marg, Mumbai, 400012, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ira","family":"Shah","sequence":"additional","affiliation":[{"name":"Bai Jerbai Wadia Hospital for Children Department of Pediatric Gastroenterology and Hepatology, , Acharya Donde Marg, Mumbai, 400012, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"key":"2024073112355022300_ref1","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1111\/bjd.18921","article-title":"Consensus reclassification of inherited epidermolysis bullosa and other disorders with skin fragility","volume":"183","author":"Has","year":"2020","journal-title":"Br J Dermatol"},{"key":"2024073112355022300_ref2","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1111\/j.1365-2133.2008.08507.x","article-title":"Gastrointestinal complications of epidermolysis bullosa in children","volume":"158","author":"Freeman","year":"2008","journal-title":"Br J Dermatol"},{"key":"2024073112355022300_ref3","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1097\/MPG.0b013e31812f5667","article-title":"Gastrointestinal complications of inherited epidermolysis bullosa: cumulative experience of the National Epidermolysis Bullosa Registry","volume":"46","author":"Fine","year":"2008","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2024073112355022300_ref4","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1259\/0007-1285-66-789-788","article-title":"Gastrointestinal manifestations in the Hallopeau-Siemens variant of recessive dystrophic epidermolysis bullosa","volume":"66","author":"Wong","year":"1993","journal-title":"Br J Radiol"},{"key":"2024073112355022300_ref5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13023-021-02144-1","article-title":"Epidermolysis bullosa in children: the central role of the pediatrician","volume":"17","author":"Marchili","year":"2022","journal-title":"Orphanet J Rare Dis"},{"key":"2024073112355022300_ref6","first-page":"535","article-title":"Management of esophageal strictures in children with recessive dystrophic epidermolysis bullosa","volume":"34","author":"Castillo","year":"2002","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2024073112355022300_ref7","article-title":"Balloon dilatation in esophageal strictures in epidermolysis bullosa and the role of anesthesia","volume":"30","author":"Gollu","year":"2017","journal-title":"Dis Esophagus"},{"key":"2024073112355022300_ref8","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/00005792-199205000-00002","article-title":"Gastrointestinal manifestations of epidermolysis bullosa. 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