Endoscopic Treatment of Refractory Variceal Bleed

Abstract

A 70-year-old man with history of end-stage liver disease due
to alcohol misuse disorder was admitted to the hospital with
hematemesis. He had at least 5 episodes of bright red hematemesis
and was feeling dizzy. He complained of epigastric pain for 3 days
prior to presentation. He had noticed progressive development of
dark urine, pale stools and yellow sclera. He had not consumed any
non-steroidal anti-inflammatory drugs recently.
His last consumption of alcohol was 3 months ago. He
had a prior history of gastrointestinal (GI) bleeding and had undergone
upper GI endoscopy that revealed large varices with highrisk
stigmata (white nipple sign) requiring variceal band ligation.
His last endoscopy was 6 weeks prior to presentation. He was noncompliant
with prophylactic propranolol and was not on any other
medications.