title: Spontaneous healing of gastric perforation after endoscopic ligation for gastric varices.
abstract: Endoscopic variceal ligation (EVL) can be performed as an optional therapy for gastric variceal bleeding if endoscopic sclerotherapy (ES) is not readily available or if practitioners lack experience. EVL using an endoscopic pneumo-activated ligating device was performed on a 53-year-old male patient with liver cirrhosis who presented with hematemesis. Follow-up esophagogastroduodenoscopy (EGD) performed two days after the EVL showed gastric perforation at the EVL-procedure site on the gastric fundus. However, the patient refused emergency surgery, and therefore received only supportive management, including intravenous antibiotics. EGD 10 days later showed healing of the perforation site. This is the first report of a case of gastric variceal bleeding with development of a gastric perforation soon after EVL, which showed complete recovery with conservative therapy and without surgical intervention.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Hong Dae
authors.initials: HD
authors.lastname: Ahn
authors.forename: Kwang An
authors.initials: KA
authors.lastname: Kwon
authors.forename: Yoon Jae
authors.initials: YJ
authors.lastname: Kim
authors.forename: Jun-Won
authors.initials: JW
authors.lastname: Chung
authors.forename: Dong Kyun
authors.initials: DK
authors.lastname: Park
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D016145:Endoscopy, Digestive System; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D008026:Ligation / Q000009:adverse effects; D008103:Liver Cirrhosis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
keywords: Endoscopy; Hemostasis; Intestinal Perforation; Ligation; Varix