Endoscopic injection sclerotherapy with n-butyl-2-cyanoacrylate for ruptured duodenal varices |
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Authors: | Kazuhiro Ota Zentaro Shirai Takao Masuzaki Keiichi Tanaka Hideyuki Higashihara Masatoshi Okazaki Masahiro Arakawa |
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Affiliation: | (1) Department of Emergency and Critical Care Medicine, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan, JP;(2) First Department of Internal Medicine, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan, JP;(3) Department of Radiology, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan, JP;(4) Department of Pathology, Omuta City General Hospital, Omuta, Japan, JP |
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Abstract: | 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. (Received July 9, 1997, accepted Nov. 28, 1997) |
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Keywords: | : duodenal varices endoscopic injection sclerotherapy Histoacryl |
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