Duodenal varices successfully treated with cyanoacrylate injection therapy

Duodenal varices are a rare complication of portal hypertension secondary to liver cirrhosis. Compared to oesophageal varices, they bleed less often but are also more difficult to diagnose and treat. There is no established treatment for bleeding duodenal varices and different treatment strategies h...

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Bibliographic Details
Published in:BMJ case reports 2011-05, Vol.2011 (may24 2), p.bcr0220113913-bcr0220113913
Main Authors: Malik, Ahsan, Junglee, Naushad, Khan, Anwar, Sutton, Jonathon, Gasem, Jaber, Ahmed, Waqar
Format: Article
Language:English
Subjects:
Abdomen
Cyanoacrylates - therapeutic use
Duodenum - blood supply
Endoscopy
Endoscopy, Digestive System
Europe (West)
Gastroenterology
Hemoglobin
Hemostasis, Endoscopic - methods
Humans
Hypertension
Liver diseases
Male
Melena - etiology
Middle Aged
Novel Treatment (New Drug/Intervention
Established Drug/Procedure in New Situation)
Patients
Sclerotherapy
Small intestine
Tissue Adhesives - therapeutic use
Varicose Veins - complications
Varicose Veins - diagnosis
Varicose Veins - therapy
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Summary:Duodenal varices are a rare complication of portal hypertension secondary to liver cirrhosis. Compared to oesophageal varices, they bleed less often but are also more difficult to diagnose and treat. There is no established treatment for bleeding duodenal varices and different treatment strategies have been employed with variable results. The authors present a case of 52-year-old male who was admitted with melaena. Upper gastrointestinal endoscopy was performed which identified bleeding varices in the second part of duodenum. The varices were injected with cyanoacrylate and the outcome was favourable. Subsequent endoscopies showed complete resolution of the varices. The authors conclude that cyanoacrylate injection is an effective first-line treatment for bleeding duodenal varices.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.02.2011.3913