Biodegradable stent for the treatment of a colonic stricture in Crohn’s disease

Abstract

Biodegradable polydioxanone stents were developed for the treatment of refractory benign esophageal strictures but have been suggested as a new therapeutic option for intestinal strictures. The primary advantage of biodegradable stents over self-expandable metallic stents is that removal is not required. There are, however, few data available on their use in the small or large bowel. We herein describe the case of a 33-year-old patient with long-standing Crohn’s disease (CD) who developed a fibrotic stricture of the sigmoid too long to be amenable to balloon dilation. The use of a biodegradable polydioxanone stent was chosen to avoid surgery. Combined endoscopic and fluoroscopic placement of the stent was technically simple, safe and clinically successful, and no recurrence of obstructive symptoms occurred during a 16-mo follow-up. Further studies are needed to evaluate the long-term efficacy and safety of biodegradable stents in the treatment of intestinal strictures, particularly in the context of CD.

Keywords: Crohn’s disease; Fibrosis; Intestinal obstruction; Stents; Polydioxanone

Core tip: Strictures in Crohn’s disease (CD) are challenging. Until the development of medical therapy that can prevent or reverse intestinal fibrosis, endoscopic management is recommended to avoid surgery. Biodegradable polydioxanone stents originally developed to treat refractory esophageal benign strictures are a promising alternative to balloon dilation with the advantage over metallic stents that they do not need to be removed. However, data on their use in the bowel is limited to a few series, mostly in patients with postsurgical colorectal strictures. We report the case of a CD patient presenting with a symptomatic colonic fibrotic stricture that was successfully treated with a biodegradable stent.