Out-of-the-box management for unexpected complications after band ligation of esophageal varices

Another indication for through the scope clips outside the guidelines A 63-year-old woman underwent upper digestive endoscopy as a follow-up endotherapy for esophageal varices. After band ligation of esophageal varices, the barrel of the band ligator was detached from the scope and fell into the patient’s esophagus. Multiple trials to remove the barrel using biopsy forceps failed. Other attempts using the ERCP basket also failed. Using the ENT Magill also failed. There are no foreign body forceps or retrieval net. Also, we did not need to push the barrel into the stomach to avoid disrupting the recently banded varices. Instead, we use the scope clips to attach to the barrel firmly, and without firing the clips, we slowly remove the barrel with the scope’s withdrawal. The scope was done by dr Salem Youssef, dr Mansour Gendia, dr Omar akela. Assistants: Ms. Leila Anesthesia: dr Ahmed Abdelmoez.