[Oesophageal and fundic variceal bleeding]

[Endoscopic ligation in treatment and prevention of bleeding from esophageal varices]

AIM

To demonstrate the efficacy of endoscopic ligation in treatment and prevention of bleeding from esophageal varices in patients with liver cirrhosis and portal hypertension.

MATERIAL AND METHODS

We performed a retrospective analysis of 338 patients with liver cirrhosis who underwent ligation for the period 2009 - May 2016. There were 209 (61.8%) men and 129 (38.2%) women. In this group 511 ligations were performed. The total number of ligated nodes was 4086.

RESULTS AND DISCUSSION

Ligation was effective in 502 (98.2%) cases. In 9 (1.8%) cases endoscopic ligation was ineffective and Blackmore tube was required. The main cause of failed procedure was pre- or intraoperative active bleeding from esophageal varices. Complications in this group can be considered 3 cases of bleeding during ligation.

CONCLUSION

Endoscopic ligation is highly effective (from an economic and medical points of view) treatment and prevention of bleeding from esophageal varices in patients with liver cirrhosis.

Volunteer Case Series of a New Telemetric Sensor for Blood Detection in the Upper Gastrointestinal Tract: The HemoPill

BACKGROUND

An acute upper gastrointestinal bleeding event is an emergency situation which requires immediate endoscopic assessment and treatment. A new telemetric real-time intracorporeal bleeding sensor can help in the timely diagnosis of an acute upper gastrointestinal bleeding event: The sensor capsule, HemoPill, is swallowed by the patient if gastrointestinal bleeding is suspected. Information about the bleeding status is displayed by telemetric communication of the capsule with an extracorporeal receiver. This is the first evaluation of the HemoPill to detect blood in the upper human gastrointestinal tract.

METHODS

A voluntary test person ate a defined meal with or without the adjunct of his own blood for a total of eight times and afterward swallowed the sensor capsule. The collected spectrometric receiver data were analyzed to assess whether the sensor system was capable of detecting blood and to evaluate the effect of stomach content as an artifact.

RESULTS

With its optical sensor, the HemoPill was able to reliably indicate the ingested blood in the stomach. The data transmission from the swallowed sensor capsule to the extracorporeal receiver was achieved consistently. The evaluation of diverse concentrations of ingested blood and the respective sensor signals led to an exponential relationship of these variables. This relationship allows to define thresholds for categories indicating the likelihood of blood presence in the gastrointestinal tract.

CONCLUSIONS

The HemoPill is a valuable tool to detect an acute upper gastrointestinal bleeding event without the need of endoscopy.