Extreme hyperbilirubinemia induced by endoscopic injection sclerotherapy in a patient with esophageal varices and thalassemia: report of a case

We describe herein the case of a 57-year-old man with thalassemia who developed acute liver failure after undergoing endoscopic injection sclerotherapy (EIS) to control hemorrhage from a ruptured esophageal varix. The patient, who had been confirmed as having liver cirrhosis due to chronic hepatitis...

Full description

Saved in:
Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 1996, Vol.26 (1), p.53-56
Main Authors: Nishioka, K, Hashizume, M, Kitano, S, Ohta, M, Ueno, K, Tomikawa, M, Higashi, H, Okamura, T, Sugimachi, K
Format: Article
Language:English
Subjects:
Biopsy
Erythrocytes - pathology
Esophageal and Gastric Varices - pathology
Esophageal and Gastric Varices - therapy
Fatal Outcome
Hepatitis C - complications
Hepatitis C - pathology
Humans
Hyperbilirubinemia - pathology
Liver - pathology
Liver Cirrhosis - complications
Liver Cirrhosis - pathology
Liver Failure - pathology
Liver Function Tests
Male
Middle Aged
Sclerotherapy
Thalassemia - pathology
Thalassemia - therapy
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We describe herein the case of a 57-year-old man with thalassemia who developed acute liver failure after undergoing endoscopic injection sclerotherapy (EIS) to control hemorrhage from a ruptured esophageal varix. The patient, who had been confirmed as having liver cirrhosis due to chronic hepatitis C with thalassemia in 1989, was admitted to our department to undergo EIS for esophageal varices, at which time his serum total bilirubin level was 5.5 mg/dl. As a small amount of hematemesis occurred just after a percutaneous transhepatic portography was performed, emergency EIS was carried out, following which the serum total bilirubin level markedly increased, mainly with a direct fraction, until it reached 70 mg/dl. The patient eventually died from acute liver failure with extreme hyperbilirubinemia on the 27th day after experiencing hematemesis despite all treatment. This unfortunate case demonstrates that sclerotherapy could be an inappropriate method of treatment for patients with hemolytic disease.
ISSN:0941-1291
1436-2813
DOI:10.1007/BF00311993