Esophageal stent placement for acute variceal hemorrhage: a case report

Abstract

Esophageal stent placement as salvage therapy for acute variceal hemorrhage can serve as a bridge to definitive therapy. We discuss technical considerations of placing an esophageal stent under emergent conditions. A 47-year-old man presented with recurrent acute variceal hemorrhage. Bleeding varix was not able to be treated with band ligation because the varix could not be suctioned into the ligation device cap because of scarring from previous banding. A fully covered esophageal stent of appropriate size was selected and placed as a bridge to definitive therapy with special attention to technique to minimize ongoing bleeding, which we further describe in our case. The patient received a transjugular intrahepatic portosystemic shunt, and the esophageal stent was removed. The patient did not have any further bleeding. A fully covered esophageal stent can serve as a bridge to definitive treatment of variceal hemorrhage. Stent selection is important, and endoscopists should be prepared to place the stent under emergent conditions.