Endoscopic Treatment of Duodenal Bleeding Caused by Direct Hepatocellular Carcinoma Invasion with an Ethanol Injection.
- Author:
Jin Nam KIM
1
;
Hong Sik LEE
;
Seung Young KIM
;
Jung Han KIM
;
Sung Woo JUNG
;
Ja Seol KOO
;
Hyung Joon YIM
;
Sang Woo LEE
;
Jae Hyun CHOI
;
Chang Duck KIM
;
Ho Sang RYU
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Endoscopic treatment;
Ethanol injection;
Duodenal bleeding;
Hepatocellular carcinoma
- MeSH:
Argon Plasma Coagulation;
Carcinoma, Hepatocellular;
Cytochrome P-450 CYP1A1;
Dyspnea;
Endoscopy;
Endoscopy, Digestive System;
Epinephrine;
Ethanol;
Follow-Up Studies;
Gastrointestinal Tract;
Hemorrhage;
Humans;
Melena;
Middle Aged;
Phenobarbital;
Ulcer
- From:Gut and Liver
2012;6(1):122-125
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a case of a man who developed duodenal bleeding caused by direct hepatocellular carcinoma (HCC) invasion, which was successfully treated with endoscopic ethanol injection. A 57-year-old man with known HCC was admitted for melena and exertional dyspnea. He had been diagnosed with inoperable HCC a year ago. Urgent esophagogastroduodenoscopy (EGD) showed two widely eroded mucosal lesions with irregularly shaped luminal protruding hard mass on the duodenal bulb. Argon plasma coagulation and Epinephrine injection failed to control bleeding. We injected ethanol via endoscopy to control bleeding two times with 14 cc and 15 cc separately without complication. Follow-up EGD catched a large ulcer with necrotic and sclerotic base but no bleeding evidence was present. He was discharged and he did relatively well during the following periods. In conclusion, Endoscopic ethanol injection can be used as a significantly effective and safe therapeutic tool in gastrointestinal tract bleeding caused by HCC invasion.
