Implantation of self-expanding metal stent in the treatment of severe bleeding from esophageal ulcer after endoscopic band ligation.

Endoscopic variceal ligation is superior to sclerotherapy because of its lower rebleeding and complication rates. However, ligation may be associated with life-threatening bleeding from postbanding esophageal ulcer. We report a case of a 49-year-old male with massive hemorrhage from esophageal ulcer on 8th day after successful band ligation of bleeding esophageal varices caused by postviral liver cirrhosis (Child-Pugh class C). A removable polyurethane membrane-covered self-expanding metal stent (SX-ELLA stent Danis, 135 mm × 25 mm, ELLA-CS, Hradec-Kralove, Czech Republic) was inserted in ICU for preventing fatal hemorrhage. Complete hemostasis was achieved and stent was removed after 8 days without rebleeding or any complications. To the best of our knowledge, this is the first report in English literature regarding life-threatening hemorrhage from postbanding esophageal ulcer successfully treated by self-expanding metal stent in a patient with portal hypertension.

Sporadic retroperitoneal aggressive fibromatosis: report of a case.

We describe herein a case of sporadic retroperitoneal aggressive fibromatosis. A 54-year-old man with a palpable abdominal mass was referred to our hospital for investigation and treatment. Abdominal ultrasonography and computed tomography revealed a solid mass with relatively well-defined borders in the left abdominal retroperitoneum. At surgery, a large tumor (14 x 13 x 11 cm) was found, arising from the retroperitoneal space and involving the wall of jejunum. Complete removal was achieved. Histological examination of the resected specimen revealed the presence of changes consistent with aggressive fibromatosis. The patient was not scheduled for any further treatment. Two years after surgery, the patient is without any signs of recurrent disease. Although extremely rare, aggressive fibromatosis should be considered in the differential diagnosis of retroperitoneal masses. Complete surgical resection with negative pathological margins remains the first line management of these neoplasms. Careful follow-up is indicated because recurrence may occur every time after surgery.