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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.
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. The procedure ...
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. This same principle underlies banding as treatment for hemorrhoids. [2]
The role of transparent cap is to stabilize the bleeding site and reduce the effects of peristalsis. Band ligation technique is relatively simple compared to other hemostatic techniques. [5] Band ligation is recommended for individuals with esophageal varices or portal hypertension. [40]
Endoscopic image of esophageal varices being ligated with rubber bands. The varix being ligated has a longitudinal red mark on it, termed the wale mark. A wale mark, red wale sign or wale sign is an endoscopic sign suggestive of recent hemorrhage, or propensity to bleed, seen in individuals with esophageal varices at the time of endoscopy.
Sclerotherapy has also been used in the treatment of gastric varices since the late 1980s. [5] In this case Histoacryl glue (cyanoacrylate) is commonly used as the sclerosant. [6] This technique is favoured over band ligation because the position of the varices in the stomach, most often in the gastric fundus, makes the placing of bands very ...
The esophageal branch of the left gastric vein drains into the azygos vein. In cases of portal hypertension, this communication allows for blood to bypass the portal vein and reach systemic circulation. As a result of this anastomosis, development of esophageal and paraesophageal varices is possible. [3]
Used to perform variceal band ligation: Sengstaken–Blakemore tube: Used in the management of bleeding esophageal varices: Balloon dilator: Used to perform esophageal balloon dilatation, pyloric dilatation or ileocolonic dilatation Savary-Gilliard dilator: Used to perform esophageal bougie dilatation: Heater probe