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        Removal of Esophageal Variceal Bands to Salvage Complete Esophageal Obstruction

        Ala’ A Abdel Jalil,Ghassan Hammoud,Jamal A Ibdah,Sami Samiullah 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.5

        Esophageal varices develop in almost half of the patients with cirrhosis, and variceal hemorrhage constitutes an ominous sign with anincreased risk of mortality. Variceal banding is considered an effective and mostly safe measure for primary and secondary prophylaxis. Although adverse events related to banding including dysphagia, stricture formation, bleeding, and ligation-induced ulcers have beendescribed, complete esophageal obstruction is rare, with only 10 reported cases in the literature. Among those cases, 6 were managedconservatively; 1 patient had esophageal intraluminal dissection from an attempt to remove the bands using biopsy forceps butultimately recovered with conservative management. Three patients developed strictures following removal of the bands, requiringrepeated sessions of dilation therapy. We report on a patient who developed absolute dysphagia and complete esophageal obstructionafter variceal banding. We successfully used the endoloop cutter hook to release the bands intact and restore luminal integrity.

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