Yang GC, Mo YX, Zhang WH, Zhou LB, Huang XM, Cao LM. Endoscopic clipping for the secondary prophylaxis of bleeding gastric varices in a patient with cirrhosis: A case report.
World J Clin Cases 2022;
10:1447-1453. [PMID:
35211582 PMCID:
PMC8855171 DOI:
10.12998/wjcc.v10.i4.1447]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/07/2021] [Accepted: 12/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND
Bleeding from gastroesophageal varices (GOV) is a serious complication in patients with liver cirrhosis, carrying a very high mortality rate. For secondary prophylaxis against initial and recurrent bleeding, endoscopic therapy is a critical intervention. Endoscopic variceal clipping for secondary prophylaxis in adult GOV has not been reported.
CASE SUMMARY
A 66-year-old man with cirrhosis was admitted to our hospital complaining of asthenia and hematochezia for 1 wk. His hemoglobin level and red blood cell counts were significantly decreased, and his fecal occult blood test was positive. An enhanced computed tomography of the abdomen showed GOV. The patient was diagnosed with hepatitis B cirrhosis-related GOV bleeding. A series of palliative treatments were administered, resulting in significant clinical improvement. Subsequently, an endoscopic examination revealed severe gastric fundal varices, prompting endoscopic variceal clipping. There were no further episodes of gastrointestinal bleeding. The GOV improved significantly on follow-up imaging and was confirmed as improved on endoscopy at the 5th postoperative month.
CONCLUSION
Our results suggest that endoscopic clipping is an inexpensive, safe, easy, effective, and tolerable method for the secondary prophylaxis of bleeding from gastric type 2 GOV. However, additional research is indicated to confirm its long-term safety and efficacy.
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