Abstract
BackgroundPost-variceal band ligation bleeding ulcer is a severe complication with considerable mortality. We tried evaluating self-expandable metallic stent (SEMS) with concern to the ulcer morphology not well studied.ResultsWe did a retrospective analysis of patients with bleeding post-band ulcers and treated by SEMS with concern to control bleeding and 6 weeks survival. Twenty-eight patients studied had their age (mean ± S.D.) 57.8 ± 8.6 years, and 85.7% were males. The Child-Pugh score range was 5–12]. Control of bleeding by SEMS was achieved in 23 (82.1%) patients, and overall, 6-week survival was 75%. Both post-band ulcer types B (oozing blood and type C (active spurted) were a risk for 6 weeks mortality (P = 0.04, OR 1.58, CI 95% 1.12–2.23).ConclusionSEMS is considered an excellent choice to control esophageal post-banding ulcer bleeding and a definite treatment bridge.
Highlights
Post-variceal band ligation bleeding ulcer is a severe complication with considerable mortality
Esophageal varices are portosystemic venous channels and present in about half of patients diagnosed with cirrhosis
A retrospective study conducted on 28 patients with refractory bleeding post-band ulcers admitted to a specialized tertiary center (Hepatology and Gastroenterology Department), National Liver Institute, Menuofia University, Egypt, who received fully covered self-expandable metallic stents (FCSEMS) (NITI-S Mega stents-Tae Wong-S Korea) as a management of their refractory bleeding from post-variceal band ligation ulcer between January 2017 and December 2018
Summary
Post-variceal band ligation bleeding ulcer is a severe complication with considerable mortality. Liver cirrhosis is a consequence of multiple etiologies that affect the liver. Chronic hepatitis C [1] and B viruses, non-alcoholic steatohepatitis, and alcoholic steatohepatitis are the most common leading causes of cirrhosis [2]. Patients with liver cirrhosis are classified into compensated or decompensated cirrhosis, according to Child-Pugh classification [3]. Further staging of cirrhosis depends on the development of varices, variceal bleeding, jaundice, hepatic encephalopathy, and ascites’ development. The previous staging is the clinical presentation of portal hypertension that developed because of liver cirrhosis [4]. Esophageal varices are portosystemic venous channels and present in about half of patients diagnosed with cirrhosis. When portal pressure elevated to be clinically
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