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Esophageal varices seven days after banding, showing ulceration at the site of banding. The upper two thirds of the esophagus are drained via the esophageal veins, which carry deoxygenated blood from the esophagus to the azygos vein, which in turn drains directly into the superior vena cava.
Banding is a medical procedure which uses elastic bands for constriction. Banding may be used to tie off blood vessels in order to stop bleeding, as in the treatment of bleeding esophageal varices. [1] The band restricts blood flow to the ligated tissue, so that it eventually dies and sloughs away from the supporting tissue.
It is a temporary measure: ulceration and rupture of the esophagus and stomach are recognized complications. [4] [5] A related device with a larger gastric balloon capacity (about 500 ml), the Linton–Nachlas tube, is used for bleeding gastric varices. It does not have an esophageal balloon.
Another treatment for gastric varices is injection of the varices with cyanoacrylate, first described by German surgeon Nib Soehendra and colleagues in 1986. [6] The results from two randomized trials comparing band ligation vs cyanoacrylate suggests that endoscopic injection of cyanoacrylate , known as gastric variceal obliteration or GVO is ...
TIPS is a life-saving procedure in bleeding from esophageal or gastric varices. A randomized study showed that the survival is better if the procedure is done within 72 hours after bleeding. [2] TIPS has shown some promise for people with hepatorenal syndrome. [3] It may also help with ascites. [4]
The Sugiura procedure was originally developed to treat bleeding esophageal varices and consisted mainly of an esophagogastric devascularization. It was developed in Japan in 1973 [ 1 ] as a nonshunting technique that achieved variceal bleeding hemostasis by interrupting the variceal blood flow along the gastroesophageal junction.
Treatment (banding/sclerotherapy) of esophageal varices; Injection therapy (e.g., epinephrine in bleeding lesions) Cutting off of larger pieces of tissue with a snare device (e.g., polyps, endoscopic mucosal resection) Application of cautery to tissues; Removal of foreign bodies (e.g., food) that have been ingested
Patients with portal hypertensive gastropathy may experience bleeding from the stomach, which may uncommonly manifest itself in vomiting blood or melena; however, portal hypertension may cause several other more common sources of upper gastrointestinal bleeding, such as esophageal varices and gastric varices. On endoscopic evaluation of the ...