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Emergency endoscopic variceal band ligation in a COVID‐19 patient presented with hematemesis while on mechanical ventilation
Author(s) -
El Kassas Mohamed,
Al Shafie Ahmad,
Abdel Hameed Abo Seif,
Mahdi Mamdouh
Publication year - 2020
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13694
Subject(s) - medicine , esophageal varices , ligation , endoscopy , covid-19 , personal protective equipment , pandemic , emergency department , intensive care medicine , surgery , emergency medicine , portal hypertension , gastroenterology , disease , nursing , infectious disease (medical specialty) , cirrhosis
COVID‐19, caused by severe acute respiratory syndrome coronavirus (SARS‐CoV‐2), is now a global pandemic with serious health consequences. Currently, many strict control measures are applied in health care settings, including endoscopy units, in order to limit virus spread. Several recommendations called to limit endoscopic procedures to emergent endoscopies; however, several uncertainties still exist concerning patient safety, protective measures, and infection control methods in emergency endoscopic settings. In this case report, we present a case of successful endoscopic band ligation for bleeding esophageal varices in man with COVID‐19 disease who presented with an acute attack of hematemesis while on mechanical ventilation (MV). Esophago‐gastroduodenoscopy was performed in the ICU room after preparing the setting, and revealed large, risky esophageal varices. Endoscopic band ligation was done with successful control of bleeding. Third‐level measures of medical protection were applied for the participating medical personnel, and patient monitoring was maintained all through the procedure. After the procedure, the bleeding stopped, and the patient was vitally stable and conscious. We conclude that emergency endoscopic interventions could be performed safely with appropriate arrangements in patients with confirmed COVID‐19 on MV.