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Case study| Volume 77, ISSUE 1, P136-140.e1, January 2013

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Interventions and outcomes of treatment of postbanding ulcer hemorrhage after endoscopic band ligation: a single-center case series

  • Amber Tierney
    Correspondence
    Reprint requests: Amber Tierney, MD, 2210 Richert Place, St. Louis, MO 63143
    Affiliations
    Department of Internal Medicine, Washington University, St. Louis, Missouri
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  • Bertha E. Toriz
    Affiliations
    Division of Gastroenterology-Hepatology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
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  • Somia Mian
    Affiliations
    Division of Gastroenterology-Hepatology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
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  • Kyle E. Brown
    Affiliations
    Division of Gastroenterology-Hepatology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa

    Program in Free Radical and Radiation Biology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa

    Iowa City Veterans Administration Medical Center, Iowa City, Iowa
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Published:October 12, 2012DOI:https://doi.org/10.1016/j.gie.2012.08.031
      Acute variceal hemorrhage is a significant cause of morbidity and mortality in cirrhotic patients.
      North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices
      Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices.
      Endoscopic band ligation (EBL) is the preferred treatment for acute variceal hemorrhage and is used for the primary and secondary prophylaxis of esophageal variceal bleeding.
      • Laine L.
      • el-Newihi H.M.
      • Migikovsky B.
      • et al.
      Endoscopic ligation compared with sclerotherapy for the treatment of bleeding esophageal varices.
      • Stiegmann G.V.
      • Goff J.S.
      • Michaletz-Onody P.A.
      • et al.
      Endoscopic sclerotherapy as compared with endoscopic ligation for bleeding esophageal varices.
      • Garcia-Tsao G.
      • Sanyal A.J.
      • Grace N.D.
      • et al.
      Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis.
      Complications after EBL occur in 2% to 23.7% of patients and include esophageal stricture formation, infection, and rebleeding caused by variceal hemorrhage or postbanding ulcers.
      • Laine L.
      • el-Newihi H.M.
      • Migikovsky B.
      • et al.
      Endoscopic ligation compared with sclerotherapy for the treatment of bleeding esophageal varices.
      • Stiegmann G.V.
      • Goff J.S.
      • Michaletz-Onody P.A.
      • et al.
      Endoscopic sclerotherapy as compared with endoscopic ligation for bleeding esophageal varices.
      • Garcia-Tsao G.
      • Sanyal A.J.
      • Grace N.D.
      • et al.
      Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis.
      • Lay C.S.
      • Tsai Y.T.
      • Lee F.Y.
      • et al.
      Endoscopic variceal ligation versus propranolol in prophylaxis of first variceal bleeding in patients with cirrhosis.
      • Norberto L.
      • Polese L.
      • Cillo U.
      • et al.
      A randomized study comparing ligation with propranolol for primary prophylaxis of variceal bleeding in candidates for liver transplantation.
      • Schepke M.
      • Kleber G.
      • Nürnberg D.
      • et al.
      Ligation versus propranolol for the primary prophylaxis of variceal bleeding in cirrhotics.
      The reported incidence of bleeding from postbanding ulcers alone is 2.6% to 7.3%.
      • Laine L.
      • el-Newihi H.M.
      • Migikovsky B.
      • et al.
      Endoscopic ligation compared with sclerotherapy for the treatment of bleeding esophageal varices.
      • Norberto L.
      • Polese L.
      • Cillo U.
      • et al.
      A randomized study comparing ligation with propranolol for primary prophylaxis of variceal bleeding in candidates for liver transplantation.
      • Schepke M.
      • Kleber G.
      • Nürnberg D.
      • et al.
      Ligation versus propranolol for the primary prophylaxis of variceal bleeding in cirrhotics.
      • Vieira da Rocha E.C.
      • D'Amico E.A.
      • Caldwell S.H.
      • et al.
      A prospective study of conventional and expanded coagulation indices in predicting ulcer bleeding after variceal band ligation.
      • Petrasch F.
      • Grothaus J.
      • Mössner J.
      • et al.
      Differences in bleeding behavior after endoscopic band ligation: a retrospective analysis.
      • Vanbiervliet G.
      • Giudicelli-Bornard S.
      • Piche T.
      • et al.
      Predictive factors of bleeding related to post-banding ulcer following endoscopic variceal ligation in cirrhotic patients: a case-control study.
      • Schmitz R.J.
      • Sharma P.
      • Badr A.S.
      • et al.
      Incidence and management of esophageal stricture formation, ulcer bleeding, perforation, and massive hematoma formation from sclerotherapy versus band ligation.

      Abbreviations:

      EBL (endoscopic band ligation), MELD (Model for End-Stage Liver Disease), PBUH (postbanding ulcer hemorrhage), PPI (proton pump inhibitor), TIPS (transjugular intrahepatic portosystemic shunt)
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