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Lower Esophageal (Schatzki) Ring with esophageal...

Gastroenterology Atlas

A 59 year-old male with esophageal reflux disease presenting with episodes of cough and chest pain. 14 years ago, underwent a splecnectomy

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Lower Esophageal (Schatzki) Ring with esophageal...

Gastroenterology Atlas

The image and the video display a retroflexed maneuver the Schatzki ring is appreciated with some varices. An endoscopist must be sure to diagnose a hiatal hernia in the absence of vomiting and coughs,...

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Esophageal Varices and Hiatus Hernia (1...

Gastroenterology Atlas

This 93 year-old male in a routine endoscopy was found that have both clinical entities.

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Esophageal Varices and Hiatus Hernia (2...

Gastroenterology Atlas

Hiatal hernias are relatively common and, in themselves, do not cause symptoms. For this reason, most people with hiatal hernias are asymptomatic. Hiatal hernias may predispose to reflux or worsen...

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Esophageal Varices and Hiatus Hernia (3...

Gastroenterology Atlas

Aside from de hiatus hernia the patient presents with esofageal varices No clear correlation exists between the size of a hiatal hernia and the severity of the symptoms. A very large hiatal hernia...

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Banding of esophageal varices (1 of 17)

Gastroenterology Atlas

This Sequence displays Banding of esophageal varices. Endoscopic variceal ligation, a less invasive procedure than endoscopic sclerotherapy.

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Banding of esophageal varices (2 of 17)

Gastroenterology Atlas

The esophageal varices are seen in retroflexed view. Esophageal varices eventually develop in most patients with cirrhosis, but variceal bleeding occurs in only one third of them. Treatment of patients...

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Banding of esophageal varices (3 of 17)

Gastroenterology Atlas

Suction is applied through the endoscope, and the band is released over the entrapped varix. The clear plastic cylinder of the variceal ligation device is seen attached to the end of the endoscope....

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Banding of esophageal varices (4 of 17)

Gastroenterology Atlas

More bands have been placed on the varices, resulting in spherical blebs. Note the colored elastic bands strangulating each varix at the base. A typical appearance after a band has been placed at its...

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Banding of esophageal varices (5 of 17)

Gastroenterology Atlas

As seen through the banding apparatus attached to the tip of the endoscope. Ligation therapy has been used for years as the treatment of hemorrhoids, and the technique was modified for the treatment...

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Banding of esophageal varices (6 of 17)

Gastroenterology Atlas

The video clip displays two varices with typical appearance after a band has been placed at its base. Variceal hemorrhage accounts for one third of all deaths related to cirrhosis. To date, many modalities...

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Banding of esophageal varices (7 of 17)

Gastroenterology Atlas

A varix has been ligated at the cardias.

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Banding of esophageal varices (8 of 17)

Gastroenterology Atlas

Endoscopic view of Esophageal Banding Retroflexed view of cardias, the video clip display four varices that have been banding.

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Banding of esophageal varices (9 of 17)

Gastroenterology Atlas

The video clip displays two varices that have been banding. Note the raised mucosal bleb (the varix) with a black band at the base.

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Banding of esophageal varices (10 of 17)

Gastroenterology Atlas

Follow up, 5 days after the banding. An endoscopy was performed to follow up the banding treatment; the four varices were with necrotic appearance. similar of the treatment for hemorrhoids with banding

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Banding of esophageal varices (11 of 17)

Gastroenterology Atlas

Another image and video clip of the follow up endoscopy, some varices are seen with white color due to necrosis exerted by the bands.

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Banding of esophageal varices (12 of 17)

Gastroenterology Atlas

Two necrotic varices are seen at the cardias.

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Banding of esophageal varices (13 of 17)

Gastroenterology Atlas

Retroflexed image, an ulceration is observed where the band was come off, attach to the endoscope a fibrin fragment is observed which recently has been fallen from this ulceration.

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Banding of esophageal varices (14 of 17)

Gastroenterology Atlas

A new follow up after two weeks of the variceal band treatment. Status post treatment was observed, some ulcers where the varices were found. The rubber band has already fallen off, leaving behind...

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Banding of esophageal varices (15 of 17)

Gastroenterology Atlas

The image and the video show multiple oozing ulcer.

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Banding of esophageal varices (16 of 17)

Gastroenterology Atlas

Another post ligation ulcer is observed retroflexed image. See the video clip.

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Banding of esophageal varices (17 of 17)

Gastroenterology Atlas

This image shows status post variceal banding. The scope is retroflexed in the stomach to check for gastric varices, none are seen. The ulcer is seen at the gastric cardias. Because varices tend to...

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Sequences of images and videos of a case on hemorrhage due status post rubber band ligation of esophageal varices. A 77 year-old female, one month previously she started with her first hematemesis,...

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Status post rubber band ligation of esophageal varices. Some ulcers are observed, one of them with vessel and blood clots. “Stigmata of Bleeding”. Ligation therapy has been used for years as...

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Sclerotherapy Versus Banding for Variceal Bleeding. Endoscopic sclerotherapy also reduces the rate of rebleeding, although overall mortality is not affected. The main disadvantage of endoscopic sclerotherapy...

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Retroflexed view in the esophagus some ulcers are observed to the left side.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Status post Minnesota tube insertion. Necrosis and ulceration are appreciated. Retroflexed view of the cardias.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Frontal view of the cardias. There are some ulceration at this level due to a Minnesota tube.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Endoscopy of Variceal Sclerotherapy Polydocanol 0.75% was used. Sclerotherapy injection of the bleeding area of the status post rubber band ligation.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Endoscopy Image of Variceal Sclerotherapy Successfully injected, bleeding did not recur. This sclerotherapy proved to be a life-saving procedure. The patient was discharged from the hospital on...

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Endoscopy Appearance of Variceal Sclerotherapy 12 days after the first sclerotherapy, we performed a second elective session of variceal injection. The sequences of images and videos display this...

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

1.5 ml of Polydocanol at 1.5% was injected with a 4.15 minute time delay before the injector was retracted.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

The image and video display the retraction caused by the injector as well as a slight hemorrhage which originates in the variceal wall.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

This image and the video show the third sclerotherapy applied on a large vein which presented with various red signs. Variceal appearance on endoscopy ("red signs") Red wale marks (longitudinal...

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Maintaining a certain force on the injector during 4 minutes Polydocanol was injected.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Endoscopy of Variceal Sclerotherapy The injector is retracted and a small ulcer is observed as a result of the injection.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

The fourth sclerotherapy is displayed in this image as well as the video clip.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Some bleeding is observed as a consequence of the sclerotherapy. The bleeding, which originated in the variceal wall, stopped spontaneously.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

In sequence to the images presented above, you can see hemorrhage and blood clots, consequence of the last injection. The endoscopist needs to develop a certain degree of self-confidence.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

This post-procedure control image shows no active bleeding. After a period of observation the procedure was considered complete. The patient was discharged from the hospital the next day. The image...

views: 326 comments: 0

Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Two years later the patient re-bleeds, She had not taken a suitable medical control, the cirrhosis has progressed, now with ascitis. The hemoglobin was 6.0 gr/dl.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

The image and the video display bleeding from esophageal varix.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Many varices are appreciated with “the red sign”.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

The exactly site of bleeding was located at the anterior wall of the esophagus near two cm. of the gastroesophageal junction.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

Another image and the video of the site of bleed.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

We beging with the procedure to banding the varix.

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Hemorrhage due status post rubber band ligation...

Gastroenterology Atlas

The bleeding has been stopped, tree varix were ligated. Patient was discharged from the hospital with an appointment to eradicate the varices with the same method.

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Esophageal Achalasia (1 of 10)

Gastroenterology Atlas

This 32 year old man has been suffering from esophageal achalasia for about 10 years, which he has managed by meticulously cutting and chewing all his food. At that time they offered him a surgery,...

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Esophageal Achalasia (3 of 10)

Gastroenterology Atlas

Barium Swallow. Barium sulfate is a metallic compound that shows up on x-ray and is used to help see abnormalities in the esophagus and stomach. When taking the test, you drink a preparation containing...

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Esophageal Achalasia (4 of 10)

Gastroenterology Atlas

These problems can be detected with a barium swallow: 1.Narrowing or irritation of the esophagus (the muscular tube between the back of the throat and the stomach) 2. Disorders of swallowing 3. Hiatal...

views: 228 comments: 0