Preliminary experience of the use of self-expanding nititol stent in refractory variceal bleeding: a real-world study.

BACKGROUND AND AIMS: The fully-covered self-expanding metal stent (SEMS) has a role in the management of refractory acute variceal haemorrhage. The aim of this study was to evaluate its effectiveness and complications in real-world practice. PATIENTS AND METHODS: An observational, descriptive, multicenter study was carried out. Eight patients with clinically significant portal hypertension who underwent a SEMS were included. RESULTS: SEMS placement controlled acute bleeding in 7 patients with technical success. Stents were removed after a median of 8 days. Rescue transjugular intrahepatic portosystemic shunt was performed around 48 hours after SEMS placement. Four patients survived after successful SEMS removal. The most common adverse event was stent loop in 2 patients. CONCLUSIONS: In our experience, SEMS was highly effective in controlling acute refractory variceal bleeding. Bleeding-related mortality rate was probably due to impossibility of TIPS implantation. Stent loop was a common limiting factor.

Symptomatic hypomagnesemia induced by proton-pump inhibitors (PPIs). A known adverse event that is worth recalling.

In 2016, the Sociedad Española de Patología Digestiva published a paper on the adverse effects of PPIs, including a position statement on their safety, with the conclusion that they are uncommon and usually of little importance. Magnesium deficiency was assessed among PPI adverse events.