ASGE Esophagology: Tailoring Management from Testing to Treatment (On-Demand) | July 2022-CASE Based Discussion Session 2

Video Transcription

Video Summary

In this video, the speaker discusses two cases involving esophageal emergencies. The first case is about a 46-year-old male with decompensated cirrhosis and a history of variceal bleed. The patient presents with melena and a hemoglobin level of 8. The speaker discusses the use of banding to treat the variceal bleed, but it is unsuccessful. They then attempt to use glue and sclerosant injections, but these interventions also fail. Finally, they consider placing a covered esophageal stent or performing a transjugular intrahepatic portosystemic shunt (TIPS) procedure. The speaker emphasizes the importance of multidisciplinary care and quick thinking in managing these cases.<br /><br />The second case involves a 92-year-old female with a history of achalasia who presents with frank hematemesis. The speaker describes the use of a chest x-ray and CT scan to evaluate the patient's condition. The CT scan reveals a distended esophagus with a large intramural hematoma. The speaker discusses the decision to perform an emergency diagnostic esophagogastroduodenoscopy (EGD) and the challenges of managing the case due to the patient's age and the presence of clots in the esophagus. Eventually, the esophagus is cleared of clots, and no obvious bleeding source is found.<br /><br />Overall, the video highlights the complexities of managing esophageal emergencies and the importance of considering the patient's overall condition and potential treatment options. The speaker emphasizes the need for a multidisciplinary approach and quick decision-making in these cases.

Asset Subtitle

Esophageal Varices
Esophageal Emergencies that get you up in the Middle of the Night?

Keywords

esophageal emergencies

variceal bleed

esophageal stent

TIPS procedure

achalasia