Endoscopic injection sclerotherapy with n-butyl-2-cyanoacrylate for ruptured duodenal varices

Duodenal varices are a rare site of hemorrhage in patients with portal hypertension, but their rupture is a serious and often fatal event. We report the case of a 77-year-old woman with cirrhosis who presented with melena. She was admitted to our Department because of prolonged shock although she ha...

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Bibliographic Details
Published in:Journal of gastroenterology 1998-08, Vol.33 (4), p.550-555
Main Authors: Ota, K, Shirai, Z, Masuzaki, T, Tanaka, K, Higashihara, H, Okazaki, M, Arakawa, M
Format: Article
Language:English
Subjects:
Aged
Duodenoscopy
Duodenum - blood supply
Enbucrilate - analogs & derivatives
Enbucrilate - therapeutic use
Female
Gastrointestinal Hemorrhage - etiology
Humans
Hypertension, Portal - complications
Sclerosing Solutions - therapeutic use
Sclerotherapy
Tissue Adhesives - therapeutic use
Varicose Veins - complications
Varicose Veins - pathology
Varicose Veins - therapy
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Description
Summary:Duodenal varices are a rare site of hemorrhage in patients with portal hypertension, but their rupture is a serious and often fatal event. We report the case of a 77-year-old woman with cirrhosis who presented with melena. She was admitted to our Department because of prolonged shock although she had received a large blood transfusion. Upper gastrointestinal endoscopy revealed nodular varices in the third portion of the duodenum which were considered to be the source of the bleeding. Endoscopic injection sclerotherapy (EIS) with n-butyl-2-cyanoacrylate (Histoacryl; Braun-Melsungen, Germany), an adhesive agent, was performed. We injected 1.5 ml of Histoacryl with Lipiodol (Laboratoire-Guerbet, France) intravariceally and achieved successful hemostasis. This patient's duodenal varices had almost completely resolved 1 month after EIS. We conclude that EIS with Histoacryl is an effective hemostatic measure for ruptured duodenal varices.
ISSN:0944-1174
1435-5922
DOI:10.1007/s005350050131