Removal of Esophageal Variceal Bands to Salvage Complete Esophageal Obstruction
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Esophageal varices develop in almost half of the patients with cirrhosis, and variceal hemorrhage constitutes an ominous sign with anincreased risk of mortality. Variceal banding is considered an effective and mostly safe measure for primary and secondary prophylaxis. Although adverse events related to banding including dysphagia, stricture formation, bleeding, and ligation-induced ulcers have beendescribed, complete esophageal obstruction is rare, with only 10 reported cases in the literature. Among those cases, 6 were managedconservatively; 1 patient had esophageal intraluminal dissection from an attempt to remove the bands using biopsy forceps butultimately recovered with conservative management. Three patients developed strictures following removal of the bands, requiringrepeated sessions of dilation therapy. We report on a patient who developed absolute dysphagia and complete esophageal obstructionafter variceal banding. We successfully used the endoloop cutter hook to release the bands intact and restore luminal integrity.
Abstract
Esophageal varices develop in almost half of the patients with cirrhosis, and variceal hemorrhage constitutes an ominous sign with anincreased risk of mortality. Variceal banding is considered an effective and mostly safe measure for primary and secondary prophylaxis. Although adverse events related to banding including dysphagia, stricture formation, bleeding, and ligation-induced ulcers have beendescribed, complete esophageal obstruction is rare, with only 10 reported cases in the literature. Among those cases, 6 were managedconservatively; 1 patient had esophageal intraluminal dissection from an attempt to remove the bands using biopsy forceps butultimately recovered with conservative management. Three patients developed strictures following removal of the bands, requiringrepeated sessions of dilation therapy. We report on a patient who developed absolute dysphagia and complete esophageal obstructionafter variceal banding. We successfully used the endoloop cutter hook to release the bands intact and restore luminal integrity.
참고문헌 (17)
- Garcia-Tsao G, "Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis", Hepatology, 46, pp.922~938 (2007)[DOI]
- Merli M, "Incidence and natural history of small esophageal varices in cirrhotic patients", J Hepatol, 38, pp.266~272 (2003)
- D'Amico G, "Upper digestive bleeding in cirrhosis. Post-therapeutic outcome and prognostic indicators", Hepatology, 38, pp.599~612 (2003)
- Khuroo MS, "Meta-analysis: endoscopic variceal ligation for primary prophylaxis of oesophageal variceal bleeding", Aliment Pharmacol Ther, 21, pp.347~361 (2005)[DOI]
- Gluud LL, "Banding ligation versus beta-blockers for primary prevention in oesophageal varices in adults", Cochrane Database Syst Rev (2012)
- Petrasch F, "Differences in bleeding behavior after endoscopic band ligation: a retrospective analysis", BMC Gastroenterol, 10, pp.5~ (2010)[DOI]
- Saltzman JR, "Complications of esophageal variceal band ligation", Gastrointest Endosc, 39, pp.185~186 (1993)[DOI]
- Elizondo-Rivera RL, "Complete esophageal obstruction after endoscopic variceal band ligation", Endoscopy, 46(Suppl 1 UCTN), pp.E457~E458 (2014)[DOI]
- Nawaz A, "Complete esophageal occlusion following esophageal variceal band ligation: an unusual complication: a case report", Visible Human Journal of Endoscopy, 9, pp.1~4 (2010)
- de Melo SW, "Complete esophageal occlusion after band ligation", Endoscopy, 43(Suppl 2 UCTN), pp.E259~ (2011)[DOI]
- Kwiatt JT, "Successful removal of an esophageal band causing complete esophageal obstruction after variceal ligation", Gastrointest Endosc, 83, pp.1030~1031 (2016)[DOI]
- Chahal H, "Complete esophageal obstruction following endoscopic variceal band ligation", J Community Hosp Intern Med Perspect, 3 (2013)
- Verma D, "Complete esophageal obstruction: an ususual complication of esophageal variceal ligation", Endoscopy, 41(Suppl 2), pp.E200~E201 (2009)[DOI]
- Nikoloff MA, "Complete esophageal obstruction following endoscopic variceal ligation", Gastroenterol Hepatol (N Y), 7, pp.557~559 (2011)
- Maric L, "Endoscopic variceal band ligation leading to acute onset dysphagia", Am J Gastroenterol, 111, pp.S692~ (2016)
- Mansour M, "Complete esophageal obstruction after endoscopic variceal band ligation in a patient with a sliding hiatal hernia", ACG Case Rep J, 4, pp.e8~ (2017)
- Goff JS, "Endoscopic sclerotherapy versus endoscopic variceal ligation: esophageal symptoms, complications, and motility", Am J Gastroenterol, 83, pp.1240~1244 (1988)