Rubber band ligation of hemorrhoids: A guide for complications.

Content Provider	Europe PMC
Author	Albuquerque, Andreia
Copyright Year	2016
Abstract	Rubber band ligation is one of the most important, cost-effective and commonly used treatments for internal hemorrhoids. Different technical approaches were developed mainly to improve efficacy and safety. The technique can be employed using an endoscope with forward-view or retroflexion or without an endoscope, using a suction elastic band ligator or a forceps ligator. Single or multiple ligations can be performed in a single session. Local anaesthetic after ligation can also be used to reduce the post-procedure pain. Mild bleeding, pain, vaso-vagal symptoms, slippage of bands, priapism, difficulty in urination, anal fissure, and chronic longitudinal ulcers are normally considered minor complications, more frequently encountered. Massive bleeding, thrombosed hemorrhoids, severe pain, urinary retention needing catheterization, pelvic sepsis and death are uncommon major complications. Mild pain after rubber band ligation is the most common complication with a high frequency in some studies. Secondary bleeding normally occurs 10 to 14 d after banding and patients taking anti-platelet and/or anti-coagulant medication have a higher risk, with some reports of massive life-threatening haemorrhage. Several infectious complications have also been reported including pelvic sepsis, Fournier’s gangrene, liver abscesses, tetanus and bacterial endocarditis. To date, seven deaths due to these infectious complications were described. Early recognition and immediate treatment of complications are fundamental for a favourable prognosis.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC5037334&blobtype=pdf
Journal	World Journal of Gastrointestinal Surgery [World J Gastrointest Surg]
Volume Number	8
DOI	10.4240/wjgs.v8.i9.614
PubMed Central reference number	PMC5037334
Issue Number	9
PubMed reference number	27721924
e-ISSN	19489366
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2016-09-01
Access Restriction	Open
Rights License	This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
Subject Keyword	Hemorrhoids Rubber band ligation Pain Bleeding Infection
Content Type	Text
Resource Type	Article
Subject	Gastroenterology