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

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

“…Additionally, when a postbanding ulcer forms be- fore variceal thrombosis, the underlying vessels can be exposed. 15,16 High portal pressure transmitted to these exposed vessels may increase the risk of hemorrhage from postbanding ulcers in patients with decompensated liver disease.…”

“…12,14 However, if band detachment occurs before variceal thrombosis, an ulcer can form with the underlying vessels exposed, leading to severe and fatal hemorrhage. 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.…”

Endoscopic variceal ligation-induced ulcer bleeding

“…[8,9] On the day after EVL, thrombi begin to develop in the strangulated vessels. [10] Approximately, 3 to 7 days after the banding, the rubber bands slip off and esophageal ulcerations develop, which heal within 2 to 3 weeks.…”

Predictive factors of bleeding related to post‐banding ulcer following endoscopic variceal ligation in cirrhotic patients: a case‐control study

“…These pathological findings may explain the rare re‐bleeding episodes from oesophageal ulcers following EVL 7 . Until now, only few reports of life‐threatening bleeding caused by early spontaneous slippage of rubber bands and post banding ulcer have been described 9–11 . These reports were only dealing with case reports and no large study of this complication is available in cirrhotic patients treated by EVL.…”