[A case of successful endoscopic injection sclerotherapy with N-butyl-2-cyanoacrylate for ruptured duodenal varices].
Duodenal varix is a rare cause of hemorrhage in patients with portal hypertension, however their rupture is serious and often life threatening. Treatments for duodenal variceal bleeding include endoscopic procedures, surgery, or interventional radiologic procedures. We report a case of duodenal varices rupture in a 45-year-old man with alcoholic liver cirrhosis who presented with melena and dizziness. Emergent upper endoscopy revealed large nodular varices with a ruptured erosion on the top in the distal second portion of duodenum. Two consecutive injections with 1.0 mL of n-butyl-2-cyanoacrylate (Histoacryl; Braun-Melsungen, Germany) mixed with 1.0 mL of lipiodol (Laboratoire-Guerbet, France) were performed intravariceally and achieved successful hemostasis. This suggests that endoscopic injection sclerotherapy with histoacryl may be an effective therapeutic option for the control of ruptured duodenal variceal bleeding.
Son
Byoung Kwan
BK
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Sohn
Joo Hyun
JH
Chang
Myung Hee
MH
Park
Yoon Kyung
YK
Kim
Tae Yeob
TY
Jeon
Yong Cheol
YC
D004378:Duodenal Diseases / Q000209:etiology / Q000628:therapy*; D004384:Duodenoscopy; D004386:Duodenum / Q000098:blood supply*; D004659:Enbucrilate / Q000031:analogs & derivatives* / Q000737:chemistry / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D012421:Rupture; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy; D014014:Tissue Adhesives / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014648:Varicose Veins / Q000150:complications / Q000628:therapy*
D012597:Sclerosing Solutions; D014014:Tissue Adhesives; D004659:Enbucrilate