Endoscopic clipping for the secondary prophylaxis of bleeding gastric varices in a patient with cirrhosis: A case report

doi:10.12998/wjcc.v10.i4.1447

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 10, Issue 4

This Article

Peer-Review Report of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (8067)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-2) series, Tables (1-1) series.

Item

Count

PDF

424

WORD

106

HTML

3152

Figures (1-2)

1173

Tables (1-1)

599

Sum=5454

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

657

Download

1939

Sum=2596

Feb 6, 2022 (publication date) through Mar 4, 2026

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Clinical Cases

ISSN

2307-8960

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

- Full Article with Cover (PDF)
- Full Article (XML)

Case Report

World J Clin Cases. Feb 6, 2022; 10(4): 1447-1453
Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1447

Endoscopic clipping for the secondary prophylaxis of bleeding gastric varices in a patient with cirrhosis: A case report

Guang-Chao Yang, Ya-Xian Mo, Wei-Hua Zhang, Li-Bin Zhou, Xu-Ming Huang, Li-Ming Cao

Guang-Chao Yang, Ya-Xian Mo, Wei-Hua Zhang, Li-Bin Zhou, Xu-Ming Huang, Department of Gastroenterology, Shenzhen Shiyan People's Hospital, Shenzhen 518000, Guangdong Province, China

Li-Ming Cao, Department of Internal Medicine, Shenzhen University The First Affiliated Hospital, Shenzhen 518000, Guangdong Province, China

Author contributions: Yang GC and Mo YX contributed equally to this work; Yang GC and Mo YX performed the research and revised the manuscript; Zhang WH and Zhou LB provided and analyzed the data; Huang XM designed the study and wrote the manuscript; Cao LM reviewed and revised the manuscript; all authors have read and approved the final manuscript.

Informed consent statement: Informed consent was obtained from the patient. We obtained written consent for publication from the patient.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Xu-Ming Huang, MD, Doctor, Department of Gastroenterology, Shenzhen Shiyan People's Hospital, No. 11 Jixiang Road, Bao'an District, Shenzhen 518000, Guangdong Province, China. huangxm-2007@163.com

Received: October 6, 2021
Peer-review started: October 6, 2021
First decision: October 27, 2021
Revised: November 7, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: February 6, 2022
Processing time: 109 Days and 17.4 Hours

Abstract

BACKGROUND

Bleeding from gastroesophageal varices (GOV) is a serious complication in patients with liver cirrhosis, carrying a very high mortality rate. For secondary prophylaxis against initial and recurrent bleeding, endoscopic therapy is a critical intervention. Endoscopic variceal clipping for secondary prophylaxis in adult GOV has not been reported.

CASE SUMMARY

A 66-year-old man with cirrhosis was admitted to our hospital complaining of asthenia and hematochezia for 1 wk. His hemoglobin level and red blood cell counts were significantly decreased, and his fecal occult blood test was positive. An enhanced computed tomography of the abdomen showed GOV. The patient was diagnosed with hepatitis B cirrhosis-related GOV bleeding. A series of palliative treatments were administered, resulting in significant clinical improvement. Subsequently, an endoscopic examination revealed severe gastric fundal varices, prompting endoscopic variceal clipping. There were no further episodes of gastrointestinal bleeding. The GOV improved significantly on follow-up imaging and was confirmed as improved on endoscopy at the 5^th postoperative month.

CONCLUSION

Our results suggest that endoscopic clipping is an inexpensive, safe, easy, effective, and tolerable method for the secondary prophylaxis of bleeding from gastric type 2 GOV. However, additional research is indicated to confirm its long-term safety and efficacy.

Keywords: Endoscopy; Metal clips; Gastric varices; Endoscopic variceal clipping; Secondary prophylaxis; Case report

Core Tip: Gastrointestinal bleeding as a sequela of portal hypertension can be catastrophic and fatal. For patients without secondary prevention, the rebleeding and mortality rate is high; therefore, secondary prophylaxis is vital, and endoscopic techniques are primary methods used to perform this. Our novel endoscopic technique could play a critical role in the prevention of variceal re-bleeding, and we propose that it is a safe and efficacious method for the secondary prophylaxis of Type 2 GOV rebleeding. Our work provides an idea for the further study in this field.