The Korean Journal of Gastroenterology  2007;49(5):336-340

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

Byoung Kwan SON 1 ; Joo Hyun SOHN ; Myung Hee CHANG ; Yoon Kyung PARK ; Tae Yeob KIM ; Yong Cheol JEON

Affiliations

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Keywords

Duodenal varices; Endoscopic injection sclerotherapy (EIS); Histoacryl

Country

Republic of Korea

Language

Korean

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.