Philips Cyriac A, Kumbar Sandeep, Ahamed Rizwan, Augustine Philip
Gastroenterology, Cochin Gastroenterology Group, Kochi, IND.
Gastroenterology, Ernakulam Medical Center, Kochi, IND.
Cureus. 2020 May 28;12(5):e8333. doi: 10.7759/cureus.8333.
Acute bleeding from portal hypertensive gastropathy (PHG) is an extremely rare event in the natural history of cirrhosis. The treatment recommendations include portal pressure reduction strategies including pharmacotherapy with vasoactive agents and beta-blockers and interventional strategies such as transjugular intrahepatic portosystemic shunt placement. In this report, we present the case of a patient with cirrhosis in whom acute PHG-related bleed was managed with endoscopic band ligation, a therapeutic modality which has not been described in current literature. Our decision to re-purpose a technique for variceal bleeding stems from the fact that during the ongoing COVID-19 pandemic, the technical assistance, resource availability, and sourcing of materials that were required for us to follow recommended management guidelines for acute PHG-related bleed was severely affected due to imposed lockdown between districts and states.
门静脉高压性胃病（PHG）引起的急性出血在肝硬化自然病程中极为罕见。治疗建议包括降低门静脉压力的策略，如使用血管活性药物和β受体阻滞剂进行药物治疗，以及经颈静脉肝内门体分流术等介入策略。在本报告中，我们介绍了一例肝硬化患者，其急性PHG相关出血通过内镜下套扎术进行治疗，这是一种目前文献中尚未描述的治疗方式。我们决定将一种用于静脉曲张出血的技术重新用于该病例，原因是在当前的新冠疫情期间，由于地区和州之间实施封锁，我们遵循急性PHG相关出血推荐管理指南所需的技术援助、资源可用性和材料采购受到严重影响。
