Chronology of Histological Changes after Band Ligation of Esophageal Varices in Humans

Abstract

The changes seen in the present study are similar to those described in animals. The delay in ulcer healing, compared with the gross changes reported during follow-up endoscopic examinations, may be related to the severity of the underlying illness and the compromised immune status of patients in the present series.

Early Spontaneous Slippage of Rubber Bands with Fatal Bleeding: a Rare Complication of Endoscopic Variceal Ligation

“…Several case reports have also described early slippage of bands within 24 h, as in the present case [3]. From the morphological point of view, occlusion of the variceal lumen by mature thrombus was demonstrated on day 2 after EVL and premature slippage of bands from the treated sites is associated with a high potential for bleeding [5]. Some reports [1,2] have also suggested that endoscopic intravariceal injection of cyanoacrylate glue is still the most promising approach to the management of massive variceal hemorrhage, as its success in preventing recurrent bleeding is independent of the above factors.…”

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

“…These patients were included in our study because PBUH caused by early spontaneous slippage of bands has been reported previously on day 0. 17 Because of the limited data on optimal PBUH management, there is no standard protocol for management of PBUH, and all cases were managed as dictated by the judgment of the attending gastroenterologist. As a retrospective study, follow-up was limited for some patients, and we were not able to determine morbidity after the PBUH hospitalization.…”

“…15,16 Postbanding ulcer hemorrhage (PBUH) is reported to occur most commonly between 2 and 29 days after EBL, [8][9][10]15,16 but may occur as early as day 0 because of ischemic necrosis and epithelial sloughing of the mucosa. 17 Identified risk factors for PBUH include Child-Pugh class C status, high platelet ratio index, low prothrombin index, and EBL for acute variceal bleeding. [8][9][10] Various treatments have been used to treat PBUH, including cyanoacrylate endoscopic injection, a self-expandable metal stent, balloon tamponade, and transjugular intrahepatic portosystemic shunts (TIPS).…”

Endoscopic Diagnosis and Therapy in Gastroesophageal Variceal Bleeding

“…The resultant mucosal ulceration takes 2-3 weeks for complete re-epithelialization. 11,12 It has been reported that with complete variceal obliteration, the risk of portal vein thrombosis may be increased and the development of gastric varices may be facilitated. 13 Portal hypertensive gastropathy may also worsen after successful esophageal variceal eradication by EVBL.…”