A miniature ultrasound probe is useful in reducing rebleeding after endoscopic cyanoacrylate injection for hemorrhagic gastric varices.
OBJECTIVE
To better assess the usefulness of miniature ultrasound probe (MUP) sonography in the evaluation of the adequacy of gastric variceal injection with cyanoacrylate to decrease the risk of post injection rebleeding.


METHODS
Sixty-nine patients with bleeding gastric varices were included in this study. Endoscopic cyanoacrylate injection was performed in the acute phase for variceal hemostasis. After injection, patients (n = 34) included in the MUP group prospectively received endoscopic ultrasonography (EUS) with MUP during each scheduled endoscopic follow-up session. Patients (n = 35) in the control group who were included historically were followed up with the same interval with endoscopy only.


RESULTS
Four (11.4%) patients in the control group received reinjection, and there were 10 episodes of rebleeding in 7 (20.0%) patients. Nine (26.5%) patients received reinjection due to inadequate obturation as judged by EUS. There were six episodes of rebleeding in three (8.8%) patients in the MUP group. The free-of-rebleeding rate for the MUP group was significantly higher than that for the control group (p < 0.05). The cumulative survival for the MUP group was slightly better than that for the control group but was not statistically significant. The patients' compliance in both groups was similar. The endosonographers considered the performance of MUP sonography to be convenient.


CONCLUSIONS
MUP sonography is useful for the evaluation of the adequacy of tissue adhesive obturation of gastric varices that may reduce the probability of rebleeding.
Department of Internal Medicine, Division of Gastroenterology, Taichung Veterans General Hospital , Taichung , Taiwan.
Szu-Chia
SC
Liao
Sheng-Shun
SS
Yang
Chun-Wang
CW
Ko
Han-Chung
HC
Lien
Chun-Fang
CF
Tung
Yen-Chun
YC
Peng
Hong-Zen
HZ
Yeh
Chi-Sen
CS
Chang
D000328:Adult; D000368:Aged; D004659:Enbucrilate / Q000008:administration & dosage*; D019160:Endosonography / Q000295:instrumentation*; D004932:Esophageal and Gastric Varices / Q000517:prevention & control*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015911:Sclerotherapy; D014014:Tissue Adhesives / Q000008:administration & dosage*; D016896:Treatment Outcome
D014014:Tissue Adhesives; D004659:Enbucrilate