Dislodgement of variceal bands after esophageal balloon tamponade for variceal bleeding
Journal Title: Annals of Hepatology - Year 2014, Vol 13, Issue 6
Abstract
A 43-year-old male with alcoholic cirrhosis underwent EGD for hematemesis which revealed bleeding, grade II, lower esophageal varices that were endoscopically ligated with 6 bands. All the bands remained attached to varices at the completion of EGD. Despite apparent initial hemostasis, balloon tamponade was performed one hour later for suspected continued bleeding. Due to suspected continuing bleeding, EGD was repeated 4 h after initial EGD, and 3 h after balloon tamponade. This EGD revealed the esophageal varices; none of the bands remaining on esophageal mucosa; multiple mucosal stigmata likely from trauma at initial site of variceal bands before dislodgement; and 3 dislodged bands in gastric body, duodenal bulb, or descending duodenum. The patient expired 17 h thereafter from hypovolemic shock. This single report may suggest an apparently novel, balloon tamponade complication: dislodgement of previously placed, endoscopic bands. The proposed pathophysiology is release of bands by stretching entrapped, esophageal mucosa during esophageal balloon tamponade. This complication, if confirmed, might render balloon tamponade a less desirable option very soon after band ligation.
Authors and Affiliations
Estela Mogrovejo, Palaniappan Manickam, Gregg Polidori, Mitchell S. Cappell
Keywords
Related Articles
- EP ID EP78462
- DOI -
- Views 126
- Downloads 0
Prognostic factors associated with in-hospital mortality in patients with spontaneous bacterial peritonitis
Introduction. Spontaneous bacterial peritonitis (SBP) is associated with a high in-hospital mortality rate ranging from 20-40%. The model for end-stage liver disease (MELD) has been suggested as a predictor of inhospital...
Updating the knowledge of hepatitis E: new variants and higher prevalence of anti-HEV in Argentina
Introduction. Hepatitis E is a disease of global distribution, with significant morbidity and mortality, whose scope and burden continue to emerge in low endemic countries. Material and methods. In 2012, we studied the p...
Intermediate fibrosis staging in hepatitis C: a problem not overcome by optimal samples or pathologists’ expertise
Background and aims. The prediction of intermediate stage of fibrosis in chronic hepatitis C represents a prognostic factor for disease progression. Studies evaluating biopsy performance in intermediate stage considering...
Evaluation the value of markers for prediction of portal vein thrombosis after devascularization
Aim. To evaluate the value of D-dimer and P-selectin in cirrhotic portal hypertension (PHT) patients for prediction of portal vein thrombosis (PVT) after devascularization. Material and methods. 137 patients withcirrhoti...
Epidemiological assessment of liver disease in northeastern Brazil by means of a standardized liver biopsy protocol
Background. Intestinal intussusception in adults is associated with chronic inflammatory bowel disease, celiac disease, abdominal tumors or previous abdominal surgery but most often of unknown origin. Aim. The aim of our...