Endoscopy 2001; 33(5): 443-447
DOI: 10.1055/s-2001-14259
Short Communication
© Georg Thieme Verlag Stuttgart · New York

Chronology of Histological Changes after Band Ligation of Esophageal Varices in Humans

J.M. Polski1 , E.M. Brunt1 ,  Z.A. Saeed2
  • 1 Dept. of Pathology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
  • 2 Dept. of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA
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Publikationsverlauf

Publikationsdatum:
31. Dezember 2001 (online)

Background and Study Aims: While the histological effects of endoscopic sclerotherapy in humans have been extensively described, the effects of endoscopic ligation have been reported in only two cases. The purpose of this study was to reconstruct the chronological sequence of histological changes after ligation of esophageal varices.

Patients and Methods: Autopsy specimens from six patients who received ligation of varices from nine hours to 22 months ante-mortem were evaluated for gross and microscopic changes.

Results: Early after ligation, the appearance was that of a polyp with its base compressed by the band. Variceal thrombosis was seen on day 2. Varying degrees of ischemic necrosis of the polyp were present on days 0-5. If the bands did not remain in situ for two days (premature loss), necrosis of the polyp and dilated variceal vessels were seen. On day 22, superficial ulcers were observed. After complete healing, fibrosis was seen in the submucosa.

Conclusions: The changes seen in the present study are similar to those described in animals. The delay in ulcer healing, compared with the gross changes reported during follow-up endoscopic examinations, may be related to the severity of the underlying illness and the compromised immune status of patients in the present series.

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Z. A. Saeed, M.D.

Division of Gastroenterology
Saint Louis University HSC

3635 Vista Avenue
St Louis
MO 63110
USA


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