Stricture formation

Complications from radical prostatectomy include blood loss, stricture formation, incontinence, lymphocele, fistula formation, anesthetic risk, and impotence. Nerve-sparing radical... 

Decontamination and Treatment Animals should be moved into fresh air. Emesis is not reeommended and activated charcoal administration after oral ingestion is controversial. Activated charcoal appears to have some beneficial effects if administered within 1 h of ingestion. Sodium thiosulfate (2% solution) given orally may help in cases with oral exposures (Borak and Sidell, 1992 Dacre and Goldman, 1996). Perforation and stricture formation can follow esophageal bums. 

As lewisite is a vesicant, emesis is not recommended in those species that can vomit (dogs, cats, swine, and ferrets). Dilution with milk or water is recommended. Activated charcoal is not recommended as severe irritation/vesication of the esophagus or gastrointestinal tract is likely to occur. Endoscopy can be performed very carefully to determine the extent of injury. Esophageal perforation and/or stricture formation may occur. 

Small bowel ulceration with thickening of the bowel wall and stricture formation in the terminal ileum and the ileocecal junction occurred in a patient with rheumatoid arthritis taking long-term indometacin (SEDA-12, 84). This is one reason why prolonged courses of indometacin should be avoided whenever possible, especially in elderly women. 

Fig. 6.16a-d. Crohn s disease of the colon, a Indium labelled white cell scan in active disease with widespread involvement of the caecum, transverse and descending colon, b Barium follow through demonstrating stricture formation of the ascending colon with displaced adjacent bowel consistent with an inflammatory mass, c Ultrasound of the descending colon in a patient with active disease. Note the thickened bowel wall and the obliterated bowel lumen, d Coronal MRI showing marked wall thickening of the caecal pole with a narrowed lumen... 

One unanswered question is if these minor ischemic insults could lead to delayed complications such as stricture formation. Bandi et al. [6] reported no clinically significant complications in their group of 48 patients with follow-up out to 10 years. They had ten patients with clinical follow-up and 25 with objective post-procedure evaluation (endoscopy or surgical pathology). No patient had any symptoms of an ischemic complication including six patients who had minor signs of ischemia identified at endoscopy. 

Glucocorticoids may be helpful in minimizing stricture formation however, this application is somewhat controversial. 

Whilst ulcers are more readily diagnosed by endoscopy, radiology more accurately depicts complications such as fistula and stricture formations. 

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