At that time, a repeat endoscopy and final dilation will be accomplished. Plan: Check on biopsy, continue Prilosec for at least another 30 days. Impressions: Pyloric stricture secondary to healed pyloric channel ulcer, dilated. The patient tolerated the procedure well. Follow-up biopsies were also taken to evaluate Helicobacter noted on a previous exam. Much easier access into the duodenum was accomplished after the dilation. Following the diagnostic exam, a 15 mm balloon was placed across the stricture, dilated to maximum pressure, and withdrawn. Marked deformity and scarring was seen in the proximal bulb. With some probing, the 11 mm endoscope could be introduced into the second portion of the duodenum, revealing normal mucosa. The ulcer, as previously seen, was well healed with a scar. Stomach was entered revealing normal gastric mucosa. Procedure: With the patient in the left lateral decubitus position, the Olympus GIFXQ10 was inserted into the proximal esophagus and advanced to the Z-line. This is a repeat evaluation and dilation. Operative Report Indications: This is a third follow-up EGD dilation on this 40 year-old patient for a pyloric channel ulcer which has been slow to heal with resulting pyloric stricture.
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