Emergency endoscopic esophageal variceal band ligation for active bleeding
Epublication WebSurg.com, Feb 2012;12(02). URL: http://websurg.com/doi/vd01en3621
Upper digestive bleeding is a frequent complication in cirrhotic patients. In some cases, it can be disastrous with collapse, especially considering coagulopathies in these patients. The management must be multidisciplinary involving an anesthesiologist, an endoscopist, and sometimes an interventional radiologist. Emergency variceal band ligation is the first step to achieve hemostasis once the patient has been medically stabilized. This video presents the case of a 91-year-old cirrhotic man, presenting with hepatitis C virus (HCV). He was admitted to the emergency department for massive hematemesis. Blood tests showed hemoglobin levels at 8 g/dL and the patient was hemodynamically stable. Sandostatin® injection, proton pump inhibitors (PPI), antibiotics, vitamin K were started immediately to a full dose regimen. Once fresh frozen plasma and blood transfusion have been carried out, an endoscopy was scheduled within the first 12 hours.