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Bleeding from oesophageal ulceration induced by endoscopic variceal ligation for primary prophylaxis
  1. Ravindu Sujeewa Kumarasena,
  2. Madunil A Niriella,
  3. Udaya Kalubowila,
  4. Arjuna P de Silva,
  5. Anuradha S Dassanayake,
  6. H Janaka de Silva
  1. University Medical Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka
  1. Correspondence to Professor H J de Silva, Department of Medicine, Faculty of Medicine, University of Kelaniya, P O Box 6, Thalagolla Road, Ragama, Sri Lanka; hjdes{at}

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In a recent issue of Gut García-Pagán et al1 describe a multicentre, randomised controlled trial investigating the benefit of adding endoscopic banding ligation (EBL) to pharmacological treatment in the prevention of recurrent oesophageal variceal bleeding. We were particularly interested in their finding of bleeding due to oesophageal ulceration caused by EBL. They report that bleeding requiring hospitalisation occurred in four out of 80 (5%) patients who underwent EBL in addition to receiving nadolol and mononitrate for secondary prophylaxis of oesophageal varices. This more or less negated the observed slight benefit of adding EBL to drug therapy in preventing rebleeding from varices per se.

We wish to report a similar experience of bleeding from oesophageal ulcers after EBL for primary prophylaxis …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.