title: Prophylactic endoscopic ligation of high-risk oesophageal varices in a cirrhotic patient with severe haemophilia A.
abstract: One of the main complications in cirrhosis is haemorrhage from oesophageal varices. It is serious and often fatal, especially in cirrhotic patients with haemophilia. We describe the use of endoscopic variceal ligation (EVL) for prophylaxis of oesophageal variceal bleeding in a high-risk patient, a 40-year-old Japanese man, with severe haemophilia A and liver cirrhosis caused by hepatitis C virus. He had large, coil-shaped varices with a red colour sign, predicting the likelihood of haemorrhage. Administration of omeprazole and factor VIII concentrate achieved rapid healing of the post-EVL ulcers and prevented bleeding from them. Four EVL sessions eradicated oesophageal varices completely, and he has had no recurrence of varices for 2 years, indicating that the procedure was of considerable benefit.
authors.affiliation: Second Department of Internal Medicine, Nagoya University School of Medicine, Showa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yamada
authors.forename: Y
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Y
authors.initials: Y
authors.lastname: Koyama
authors.forename: I
authors.initials: I
authors.lastname: Nakano
authors.forename: F
authors.initials: F
authors.lastname: Urano
authors.forename: Y
authors.initials: Y
authors.lastname: Katano
authors.forename: K
authors.initials: K
authors.lastname: Imada
authors.forename: H
authors.initials: H
authors.lastname: Toyoda
authors.forename: J
authors.initials: J
authors.lastname: Takamatsu
authors.forename: M
authors.initials: M
authors.lastname: Imoto
authors.forename: T
authors.initials: T
authors.lastname: Hayakawa
mesh_terms: D000328:Adult; D004724:Endoscopy; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery*; D006467:Hemophilia A / Q000150:complications*; D006470:Hemorrhage / Q000517:prevention & control*; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000209:etiology; D008297:Male