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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.
Often blood transfusions are not recommended unless the hemoglobin is less than 70 or 80 g/L. [7] [12] Treatment with proton pump inhibitors, octreotide, and antibiotics may be considered in certain cases. [5] [6] [13] If other measures are not effective, an esophageal balloon may be attempted in those with presumed esophageal varices. [2]
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 use of the tube was originally described in 1950, [1] although similar approaches to bleeding varices were described by Westphal in 1930. [2] With the advent of modern endoscopic techniques which can rapidly and definitively control variceal bleeding, Sengstaken–Blakemore tubes are rarely used at present.
People are usually stratified into having either variceal or non-variceal sources of upper gastrointestinal hemorrhage, as the two have different treatment algorithms and prognosis. [citation needed] The causes for upper gastrointestinal hemorrhage include the following: Esophageal causes (gastrorrhagia): Esophageal varices; Esophagitis ...
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
A treatment used sometimes is endoscopic band ligation. [27] In 2010, a team of Japanese surgeons performed a "novel endoscopic ablation of gastric antral vascular ectasia". [10] The experimental procedure resulted in "no complications". [10] Relapse is possible, even after treatment by argon plasma coagulation and progesterone. [21]
The National Institute for Health and Clinical Excellence (NICE) produced clinical guidelines in July 2013 recommending that all people with symptomatic varicose veins (C2S) and worse should be referred to a vascular service for treatment. [33] Conservative treatments such as support stockings should not be used unless treatment was not possible.