PROPHYLACTIC ENDOSCOPIC LIGATION OF HIGH-RISK ESOPHAGEAL-VARICES IN ACIRRHOTIC PATIENT WITH SEVERE HEMOPHILIA-A

One of the main complications in cirrhosis is haemorrhage from oesopha geal varices. It is serious and often fatal, especially in cirrhotic p atients with haemophilia. We describe the use of endoscopic variceal l igation (EVL) for prophylaxis of oesophageal variceal bleeding in a hi gh-risk patient, a 40-year-old Japanese man, with severe haemophilia A and liver cirrhosis caused by hepatitis C virus. He had large, coil-s haped varices with a red colour sign, predicting the likelihood of hae morrhage. Administration of omeprazole and factor VIII concentrate ach ieved rapid healing of the post-EVL ulcers and prevented bleeding from them. Four EVL sessions eradicated oesophageal varices completely, an d he has had no recurrence of varices for 2 years, indicating that the procedure was of considerable benefit. (C) 1998 Rapid Science Ltd.