James T. Kwiatt, MD, from GI Associates, LLC in Wauwatosa, Wisconsin, USA shares this video case “Successful removal of an esophageal band causing complete esophageal obstruction after variceal ligation.”
A patient was sent to our facility after having adverse events from an EGD with band ligation of esophageal varices. During the procedure the patient was coughing and gagging; this resulted in band ligation of all walls of the esophageal lumen resulting in esophageal obstruction. She decompensated and was high risk of aspiration, warranting urgent removal of the band. After attempting to remove the band with a biopsy forceps and a rat tooth forceps, we were able use a polyp loop cutter to remove the band. The “hook” shape of the bottom jaw of the loop cutter allowed for grasping of the band and successful removal.
Always take input from the entire endoscopy team. The nurses and techs involved in the case were instrumental in thinking of various tools and solutions to the patients problem. The entire team gave input which help us come to the solution.
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