Gastric ischemia after epinephrine injection in a patient with liver cirrhosis.
Endoscopic epinephrine injection is relatively easy, quick and inexpensive. Furthermore, it has a low rate of complications, and it is widely used for the management of nonvariceal upper gastrointestinal bleeding. There have been several case reports of gastric ischemia after endoscopic injection therapy. Inadvertent intra-arterial injection may result in either spasm or thrombosis, leading to subsequent tissue ischemia or necrosis, although the stomach has a rich vascular supply and the vascular reserve of the intramural anastomosis. In addition to endoscopic injection therapy, smoking, hypertension and atherosclerosis are risk factors of gastric ischemia. We report a case of gastric ischemia after submucosal epinephrine injection in a 51-year-old woman with hypertension and liver cirrhosis.
Department of Internal Medicine, Dong-A University College of Medicine, Busan 602-715, South Korea.
Su Young
SY
Kim
Seung-Hee
SH
Han
Kyung Han
KH
Kim
Sang Ock
SO
Kim
Sang-Young
SY
Han
Sung-Wook
SW
Lee
Yang Hyun
YH
Baek
D001706:Biopsy; D015897:Comorbidity; D016145:Endoscopy, Digestive System / Q000009:adverse effects; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007267:Injections; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D013270:Stomach / Q000098:blood supply* / Q000473:pathology; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D014662:Vasoconstrictor Agents; D004837:Epinephrine
Epinephrine; Gastric ischemia; Hematemesis; Hypertension; Liver cirrhosis