Endoscopy 2004; 36(3): 239-241
DOI: 10.1055/s-2004-814255
Case Report
© Georg Thieme Verlag Stuttgart · New York

Sclerosant Extravasation as a Complication of Sclerosing Endotherapy for Bleeding Gastric Varices

H.-C.  Cheng 1 , P.-N.  Cheng 1 , Y.-M.  Tsai 1 , H.-M.  Tsai 2 , C.-Y.  Chen 1
  • 1 Dept. of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
  • 2 Dept. of Radiology, National Cheng Kung University Hospital, Tainan, Taiwan
Weitere Informationen

Publikationsverlauf

Submitted 30 January 2003

Accepted after Revision 21 May 2003

Publikationsdatum:
26. Februar 2004 (online)

We report here the case of a 65-year-old woman who suffered intraperitoneal sclerosant leakage after endoscopic injection sclerotherapy for bleeding gastric varices. In total, 3 ml of N-butyl-2-cyanoacrylate and Lipiodol mixture was injected. The patient developed mild fever and pain over the left upper quadrant and flank after the procedure. In addition to a Lipiodol-filled gastric varix, the imaging studies disclosed a wide spread of Lipiodol over the left peritoneal cavity. The patient was kept fasting with parenteral antibiotics and nutrition. She responded well to the treatment, and all of the symptoms had subsided 6 days later.

References

  • 1 Heaton N D, Howard E R. Complications and limitations of injection sclerotherapy in portal hypertension.  Gut. 1993;  34 7-10
  • 2 Ng E KW, Chung S CS, Leong H T, Li A KC. Perforation after endoscopic injection sclerotherapy for bleeding gastric varices.  Surg Endosc. 1994;  8 1221-1222
  • 3 Bhasin D K, Malhi N JS. Variceal bleeding and portal hypertension: much to learn, much to explore.  Endoscopy. 2002;  34 119-128
  • 4 Soehendra N, Nam V C, Grimm H, Kempeneers I. Endoscopic obliteration of large oesophageal gastric varices with bucrylate.  Endoscopy. 1986;  18 25-26
  • 5 Oho K, Iwao T, Sumino M. et al . Ethanolamine oleate versus butyl cyanoacrylate for bleeding gastric varices: a nonrandomized study.  Endoscopy. 1995;  27 349-354
  • 6 Cheng P N, Sheu B S, Chen C Y. et al . Splenic infarction after Histoacryl injection for bleeding gastric varices.  Gastrointest Endosc. 1998;  48 426-427
  • 7 Türler A, Wolff M, Dorlars D, Hirner A. Embolic and septic complications after sclerotherapy of fundic varices with cyanoacrylate.  Gastrointest Endosc. 2001;  53 228-230
  • 8 Terblanche J, Yakoob H I, Bornman P C. et al . Acute bleeding varices.  Ann Surg. 1981;  194 521-530
  • 9 Sauerbruch T, Holl J, Ruckdeschel G. et al . Bacteraemia associated with endoscopic sclerotherapy of esophageal varices.  Endoscopy. 1985;  17 170-172

C.-Y. Chen, M. D.

Dept. of Internal Medicine, College of Medicine, National Cheng Kung University ·

138 Sheng-Li Road · Tainan 704 · Taiwan

Fax: + 886-6-2347270

eMail: chiungyu@mail.ncku.edu.tw