Endoscopy 2000; 32(5): 422-424
DOI: 10.1055/s-2000-9002
Case Report
Georg Thieme Verlag Stuttgart ·New York

Life-Threatening Intraabdominal Arterial Embolization After Histoacryl Injection for Bleeding Gastric Ulcer

G.  H. Lee 1 , J.  H. Kim 1 , K.  J. Lee 1 , B . M. Yoo 1 , K.  B. Hahm 1 , S.  W. Cho 1 , Y.  S. Park 2 , Y.  S. Moon 2
  • 1 Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea
  • 2 Department of Internal Medicine, Eulji University College of Medicine, Seoul, South Korea
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Publikationsverlauf

Publikationsdatum:
31. Dezember 2000 (online)

N-butyl-cyanoacrylate (Histoacryl) injection has become the treatment of choice for acutely bleeding esophagogastric varices, and is the only effective option for endoscopic treatment of gastric varices. Recent reports confirm the ability of Histoacryl injection therapy to achieve immediate hemostasis in cases of gastric ulcer bleeding or Dieulafoy ulcer, where conventional endoscopic hemostatic treatment had failed. Although the overall safety record of Histoacryl injection has been relatively good, there have been scattered cases of serious complications. Here, we present two patients showing life-threatening intraabdominal arterial embolization after Histoacryl injection. They had chronic gastric ulcers with active arterial bleeding. In spite of attempts at hemostatic treatment, complete hemostasis was not achieved. We injected Histoacryl, diluted with Lipiodol, into bleeding gastric ulcers, resulting in successful hemostasis. Soon after the procedure, intraabdominal arterial embolization developed in both patients. One patient survived and the other died. Based on these experiences, we would like to warn gastrointestinal endoscopists to be alert to these fatal complications, and we propose that less diluted Histoacryl seems to be preferable in cases of bleeding peptic ulcers.

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M.D. J. H. Kim

Dept. of Gastroenterology Ajou University School of Medicine

San 5, Wonchon-Dong

Paldal-Gu, Suwon 442-749

South Korea

Telefon: +82-331-219-5999

eMail: jinhkim@netsgo.com