Elhawari, S., Moustafa, E., Zaher, T., Elsadek, H., Abd-Elazeim, M. (2019). Frequency and Risk Factors of Post Banding Ulcer Bleeding Following Endoscopic Variceal Ligation in Patients with Liver Cirrhosis. Afro-Egyptian Journal of Infectious and Endemic Diseases, 9(4), 252-259. doi: 10.21608/aeji.2019.56710
Soha A Elhawari; Emad A Moustafa; Tarek Zaher; Hany M Elsadek; Mahmoud A Abd-Elazeim. "Frequency and Risk Factors of Post Banding Ulcer Bleeding Following Endoscopic Variceal Ligation in Patients with Liver Cirrhosis". Afro-Egyptian Journal of Infectious and Endemic Diseases, 9, 4, 2019, 252-259. doi: 10.21608/aeji.2019.56710
Elhawari, S., Moustafa, E., Zaher, T., Elsadek, H., Abd-Elazeim, M. (2019). 'Frequency and Risk Factors of Post Banding Ulcer Bleeding Following Endoscopic Variceal Ligation in Patients with Liver Cirrhosis', Afro-Egyptian Journal of Infectious and Endemic Diseases, 9(4), pp. 252-259. doi: 10.21608/aeji.2019.56710
Elhawari, S., Moustafa, E., Zaher, T., Elsadek, H., Abd-Elazeim, M. Frequency and Risk Factors of Post Banding Ulcer Bleeding Following Endoscopic Variceal Ligation in Patients with Liver Cirrhosis. Afro-Egyptian Journal of Infectious and Endemic Diseases, 2019; 9(4): 252-259. doi: 10.21608/aeji.2019.56710
Frequency and Risk Factors of Post Banding Ulcer Bleeding Following Endoscopic Variceal Ligation in Patients with Liver Cirrhosis
1Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
2Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig,Egypt
Abstract
Background and aim: Endoscopic variceal ligation (EVL) is one of the best modalities for treatment of esophageal varices. One of the most serious complications after EVL is post-banding ulcer bleeding. In this study, frequency and risk factors of EVL-induced ulcer bleeding were assessed. Methods: One hundred and twenty six patients with liver cirrhosis subjected to EVL, whether done as prophylactic or therapeutic, were followed up for two weeks for detection of occurrence of post-banding ulcer bleeding. A prospective cohort study was performed comparing the patients that bleed after EVL due to post-banding ulcer (bleeder group, n= 10) with those without this complication (non-bleeder group, n= 116). All patients received full medical history taking; complete physical examination; routine laboratory tests; Pelvi-abdominal ultrasonography; Esophago-gastro-duodenoscopy (EGD) and EVL; treatment with blood transfusion and pharmacologic agents; re-endoscopy if rebleeding occur after EVL. Results: Frequency of post–banding ulcer bleeding after EVL in patients who have liver cirrhosis was 7.9%, and its mortality within 14 days follow up was 10%. Reflux esophagitis was found to be a risk factor of post- banding ulcer bleeding (P= 0.016, OR= 8). Proton pump inhibitor (PPI) may be a protective factor against occurrence of post-banding ulcer bleeding (P= 0.054). Conclusion: Post-banding ulcer bleeding is an infrequent complication after EVL. Reflux esophagitis is considered an independent risk factor for this complication.
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