Effective Management of Esophageal Variceal Hemorrhage Complicated by Ulcerative Reflux Esophagitis Using Over-the-Scope Clip (OTSC) Following Failed Band Ligation: A Case Report.

Esophageal variceal bleeding is a severe complication of portal hypertension, often requiring immediate endoscopic intervention. We present the case of a 74-year-old male with a history of liver cirrhosis, esophageal varices, who presented with a hemodynamically relevant hemorrhage from a varix at the esophagogastric junction and a severe reflux esophagitis. Initial endoscopic band ligation (EBL) within the ulcerative reflux esophagitis, failed due to disruption of the macerated tissue leading to active variceal bleeding. Salvage therapy with an over-the-scope clip (OTSC) was performed with successful hemostasis. The patient remained stable without recurrent bleeding. This case underscores the utility of OTSC in cases where conventional band ligation of varices at the esophagogastric junction with concomitant reflux esophagitis fail.