Korean J Gastroenterol.  2007 May;49(5):336-340.

A Case of Successful Endoscopic Injection Sclerotherapy with N-butyl-2-cyanoacrylate for Ruptured Duodenal Varices

• Son BK
• Sohn JH
• Chang MH
• Park YK
• Kim TY
• Jeon YC

Abstract

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.

Keyword

Duodenal varices; Endoscopic injection sclerotherapy (EIS); Histoacryl

MeSH Terms

Duodenal Diseases/etiology/*therapy
Duodenoscopy
Duodenum/*blood supply
Enbucrilate/*analogs & derivatives/chemistry/therapeutic use
Gastrointestinal Hemorrhage/etiology/*therapy
Humans
Liver Cirrhosis, Alcoholic/complications
Male
Middle Aged
Rupture
Sclerosing Solutions/*therapeutic use
*Sclerotherapy
Tissue Adhesives/therapeutic use
Tomography, X-Ray Computed
Varicose Veins/complications/*therapy