Implantation of self-expanding metal stent in the treatment of severe bleeding from esophageal ulcer after endoscopic band ligation

Abstract

Endoscopic variceal ligation is superior to sclerotherapy because of its lower rebleeding and complication rates. However, ligation may be associated with life-threatening bleeding from postbanding esophageal ulcer. We report a case of a 49-year-old male with massive hemorrhage from esophageal ulcer on 8th day after successful band ligation of bleeding esophageal varices caused by postviral liver cirrhosis (Child-Pugh class C). A removable polyurethane membrane-covered self-expanding metal stent (SX-ELLA stent Danis, 135 mm × 25 mm, ELLA-CS, Hradec-Kralove, Czech Republic) was inserted in ICU for preventing fatal hemorrhage. Complete hemostasis was achieved and stent was removed after 8 days without rebleeding or any complications. To the best of our knowledge, this is the first report in English literature regarding life-threatening hemorrhage from postbanding esophageal ulcer successfully treated by self-expanding metal stent in a patient with portal hypertension.

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

“…[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). 10,18,19 However, most of these reports are limited to case studies; thus, the optimal strategy for management of PBUH remains undefined. We conducted a retrospective study of EBL procedures performed at our institution to assess the incidence of PBUH and clinical factors associated with its occurrence and to determine the outcome of interventions used to manage PBUH.…”

Endoprosthetics for bleeding esophageal varices

“…SEMSs could also be effective for the management of bleeding from banding-induced ulceration [23]. This complication is not infrequent and can be severe, especially in patients in whom further endoscopic therapy is difficult and in whom TIPS is contraindicated [24].…”

Pros and cons of Danis stent application in esophageal bleeding

“…[32]. У пациента с декомпенсированным (стадия С по Child-Pugh) ЦП и кровотечением на высоте продолжающе-гося пищеводного кровотечения из ВРВ пище-вода было выполнено лигирование.…”