Endoscopic band ligation in management of bleeding rectal varices in patients with liver cirrhosis

Mucosal and vascular changes in portal hypertensive colopathy are part the spectrum found throughout the gastrointestinal tract in patients with portal hypertension. The colonic lesions themselves, are usually asymptomatic and clinically insignificant, except anorectal varices which may be presented by acute or chronic lower gastrointestinal bleeding. Rectal varcies in patients with portal hypertension deserve more appertain, more evaluation and better understanding. Was to evaluate the efficacy of endoscope band ligation as a maneuver for treatment of bleeding rectal varices. This study was performed on 25 cirrhotic patients who had bleeding per-rectum due to rectal varics. Endoscopic variceal ligation [EVL] was performed every two weeks from 1 to 3 times and the patients were followed for three momths. Endoscopic band ligation was effective in controlling the rectal bleeding in all cases. After EVL for rectal varices, colonoscopy revealed ulcers and shrinkage of the varices in the rectum in all patients. Minimal bleeding from ulcers occurred in three paients during follow up. EVL for bleeding rectal varices is an effective long term management

Endoscopic management of Barrett's esophagus

Barrett's esophagus [BE] has a malignant potential. Neither acid suppression nor anti reflux surgery produce consistent or complete regression of metaplastic epithelium. Is to determine the efficacy of endoscopic therapy in management of BE. This study was carried out on 25 patients [18 males and 7 Females], with BE that was confirmed by biopsy and histopatholoay. According to the histopathological examination, 24 patients had BE with no dysplasia or low-grade dysplasia [LGD]. Ablation of Barrett's mucosa in those patients was done using argon plasma coagulation [APC]. Also, one patient who had [BE] with high-grade dysplasia [HGD]. Ablation of Barrett's mucosa in this patient was done using EMR [endoscopic mucosal resection]. As regards APC, successful ablation was achieved with complete clearance of BE in [71%] of patients and during the follow-up period only [12%] of those patients revealed buried BE glands on histopathological examinations. Complications as self-limiting chest discomfort [25%], odynophagia [20%], and temporary dysphagia [4%] were observed during the follow-up period. As regards EMR, it was performed only in one patient who had BE with HGD. The procedure was performed using lift and cut technique. EMR in this study was successful with no complications. Argon plasma coagulation [APC] ablative therapy for [BE] proved to be safe and well tolerated, with only minor self-limiting side effects. -Endoscopic mucosal resection [EMR], in ablation of BE with HGD, is an emerging and promising technique in treatment of 4splastic and malignant lesions within BE