Eosinophilic pleural effusion after gastric variceal obliteration with cyanoacrylate.
Pleuropulmonary complications after endoscopic injection sclerotherapy for treatment of esophagogastric varices are not uncommon but are usually mild and self-limited. Herein we report a male patient with liver cirrhosis who underwent endoscopic injection sclerotherapy, using a mixture of n-butyl-2-cyanoacrylate and ethiodized oil for obliteration of gastric varices. After the procedure, he developed moderate amount of left pleural effusion that persisted for a period of time and required thoracentesis and medical treatment. We believed that the inadvertent retrograde reflux of the embolized glue and ethiodized oil via the portosystemic venous collateral into the left pleura might be the possible mechanism for the development of left pleural effusion as the droplets of ethiodized oil were seen along the left pleura on the imaging studies.
Boonsarngsuk
Viboon
V
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand. bss-vb@hotmail.com
Suwatanapongched
Thitiporn
T
D000328:Adult; D004659:Enbucrilate / Q000009:adverse effects / Q000031:analogs & derivatives*; D004802:Eosinophilia / Q000139:chemically induced*; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D005119:Extravasation of Diagnostic and Therapeutic Materials; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D010996:Pleural Effusion / Q000139:chemically induced*; D011859:Radiography; D015911:Sclerotherapy / Q000379:methods; D014014:Tissue Adhesives / Q000009:adverse effects*
D014014:Tissue Adhesives; D004659:Enbucrilate