An upcoming issue of Abdominal Surgery Journal will feature a case that is believed to be a first of its kind locally.

Rade Pejic, M.D., surgeon, and Rakesh Gupta, M.D., gastroenterologist, have co-authored
"Balloon Dilatation of a Postoperative Benign Distal Sigmoid Structure."

The case study involves a 64year old white male who came to the Hospital with significant lower GI bleeding. Dr Pejic performed a left hemicolectomy to stop the bleeding on an emergency basis.

Postoperatively, a stricture occurred at the point of anastomosis. (Figure 1)

Traditionally, the management of colonic strictures required surgical intervention whereby the stricture was resected, and a new anastomosis created.

However, to avoid another major surgical procedure, it was decided to try a balloon dilatation. After Dr. Pejic tried unsuccessfully to have a major Chicago medical center accept the case, he was able to persuade Dr. Gupta to perform the procedure. "Since the patient's stricture

was caused by scar tissue, and not by a natural disease, I felt confident that we could be successful," Dr. Gupta said.

The physicians noted that after the first attempt to dilate the stricture with a colonoscope, some modest improvement (widening) was observed. Twelve days later, another attempt was made.

"This time we were convinced that an opening of sufficient size had been established," Dr. Gupta said. (Figure 2) The success of this treatment enabled Dr. Pejic to reverse the patient's colostomy and restore normal digestive function. "Nearly a year after the procedure, the patient is asymptomatic," Dr. Pejic noted.

Both physicians agree that the mutual respect and trust among two medical professionals and their patients led to positive results.

"This demonstrated what collaboration can do," Dr. Pejic said.

"I was fortunate to have the full backing of a competent surgeon who wanted to find an alternative to open surgery," Dr. Gupta added.

"I believe that quality care is a global responsibility of the medical community. Trust and cooperation among physicians help us to fulfill that responsibility. And, we're proud to say that we've done things at Saint Anthony's GI lab that they aren't even doing in Chicago," Dr. Gupta concluded.

Dr. Pejic practices at The Medical Group. Dr. Gupta's office is in Saint Anthony's Medical Arts Center.