Dig Endosc. Emergency endoscopic variceal band ligation in a COVID-19 patient presented with hematemesis while on mechanical ventilation

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Dig Endosc. 2020 Apr 14. doi: 10.1111/den.13694. [Epub ahead of print]
Emergency endoscopic variceal band ligation in a COVID-19 patient presented with hematemesis while on mechanical ventilation.


El Kassas M¹, Al Shafie A¹, Abdel Hameed AS², Mahdi M³.

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Abstract

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 existing 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 kept 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 mechanical ventilation.
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KEYWORDS:

COVID-19; Hematemesis; band ligation; endoscopic intervention; mechanical ventilation


PMID:32289878DOI:10.1111/den.13694