11^th Global Gastroenterologists Meeting

Background: Esophageal variceal bleeding is a life-threatening complication of portal hypertension with a six-week mortality rate of approximately 20%. The available data suggest that vasoactive drugs, combined with endoscopic therapy and antibiotics, are the best treatment strategy with endoscopic variceal ligation (EVL) being the endoscopic procedure of choice. Tissue adhesives, endoloops, endoscopic clipping and argon plasma coagulation (APC), have been used in the management of uncontrolled esophageal varices bleeding.

 

Methods: We reported two cases 77-year-old man with hepatitis C, Child-Pugh B cirrhosis who received EVL for esophageal variceal haemorrhage two years ago and 47-year old man with alcohol induced Child-Pugh C cirrhosis who received EVL for esophageal variceal haemorrhage one year ago included with uncontrolled esophageal varices bleeding.

 

Results: Argon plasma coagulation has been used as a recovery treatment for controlling of acute esophageal varices bleeding after unsuccessful endoscopic sclerotherapy and EVL (figure 1 and figure 2). The bleeding was controlled successfully in patients.

 

Conclusion: To our knowledge, this is the first documented case to report APC used in uncontrolled acute esophageal varices bleeding. Argon plasma coagulation can be endoscopic recovery treatment in uncontrolled esophageal varices bleeding.