title: Emergency treatment of esophageal varix incarceration in the endoscope and ligation device during endoscopic variceal rubber band ligation.
abstract: Sclerotherapy and endoscopic esophageal variceal ligation (EVL) are commonly used to treat and prevent variceal bleeding. As of today, there has been no report on an unexpected incarceration of a varix hooked on with the bands from the endoscopic EVL device. We recently experienced this emergency while using the 7-band ring endoscopic EVL device (Boston Scientific Corp., Boston, MA) for prophylaxis of variceal bleeding. In this case, the varix body itself was accidently incarcerated in the crevice of the esophageal endoscope after highly negative pressure of absorption was applied on the endoscope. In this situation, using force to take out the gastroscope was not an option as it would tear the vein and cause massive hemorrhage. We were managed to ligate the varix with rubber bands while releasing the incarceration. We observed that ligation of the varix at the same position using all seven ligation bands resulted in disappearance of the targeted varix. The surrounding esophageal mucosa became smooth after the treatment.
authors.affiliation: Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University Shanghai, China ; Department of Gastroenterology, The First Affiliate Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University Shanghai, China ; Department of Gastroenterology, The First Affiliate Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Jilin
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University Shanghai, China.
authors.forename: Yahong
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University Shanghai, China.
authors.forename: Cuili
authors.initials: C
authors.lastname: Lu
authors.affiliation: Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University Shanghai, China.
authors.forename: Shaoping
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University Shanghai, China.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University Shanghai, China.
authors.forename: Yuxin
authors.initials: Y
authors.lastname: Shi
keywords: Esophageal variceal hemorrhage; emergency situation; endoscopic esophageal variceal ligation