title: Pancreatoduodenal necrosis after endoscopic injection of cyanoacrylate to treat a bleeding duodenal ulcer: a case report.
abstract: N-butyl 2-cyanoacrylate monomer was injected at endoscopy in an attempt to control arterial bleeding from a duodenal ulcer crater. Segmental infarction of the duodenum and pancreatic head followed and necessitated pancreatoduodenectomy. Butyl 2-cyanoacrylate monomers have been used with angiography as embolization agents and with endoscopy to control variceal bleeding. To our knowledge, there are no reports of its use by endoscopic injection to stop arterial bleeding. Its potential for embolism in nonselective endoscopic injections may minimize the clinical application of butyl 2-cyanoacrylate monomers in the treatment of arterial gastrointestinal bleeding.
authors.affiliation: Division of General Surgery, Wellesley Hospital, University of Toronto, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Vallieres
authors.forename: C
authors.initials: C
authors.lastname: Jamieson
authors.forename: G B
authors.initials: GB
authors.lastname: Haber
authors.forename: R L
authors.initials: RL
authors.lastname: Mackenzie
mesh_terms: D003487:Cyanoacrylates / Q000009:adverse effects*; D004381:Duodenal Ulcer / Q000150:complications*; D004384:Duodenoscopy / Q000009:adverse effects*; D004386:Duodenum / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007238:Infarction / Q000139:chemically induced* / Q000473:pathology; D008875:Middle Aged; D009336:Necrosis; D010179:Pancreas / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D012008:Recurrence
chemical_list: D003487:Cyanoacrylates