Complete esophageal obstruction following endoscopic variceal ligation.

Endoscopic variceal ligation (EVL) is the standard-of-care therapy for treating and preventing recurrence of acute esophageal variceal hemorrhage.1 EVL can also be used to prevent a patient’s first variceal bleeding episode, particularly in patients who have medium or large varices showing high-risk signs for bleeding or patients who are intolerant to β-blocker therapy.1-3 EVL has supplanted the use of endoscopic sclerotherapy (EST), as EVL has a lower overall complication rate and equal or better efficacy for controlling acute bleeding and lowering rebleeding rates.4-11 Complications of EST include stricture formation, ulceration of esophageal mucosa, rebleeding, hematoma formation, perforation, spontaneous bacterial peritonitis, and pulmonary infec tions.3,6-9,11,12 Complications of EVL, on the other hand, are generally benign.4,6-9,11 However, dysphagia following EVL has often been reported in the literature.6,10,11,13 Complete esophageal obstruction causing dysphagia has been reported only once previously in the literature.14 We report the second case of complete esophageal obstruction following EVL. Our patient was managed conservatively and experienced a good outcome.