scholarly journals Gastric Variceal Obliteration By Cyanoacrylate Glue Injection

2012 ◽  
Vol 7 (2) ◽  
pp. 44-46
Author(s):  
SMB Hussain ◽  
MR Hossain ◽  
MM Rahman ◽  
S Parvin ◽  
MD Hossain
Keyword(s):  
Case Report ◽  
Gastrointestinal Bleeding ◽  
Variceal Bleeding ◽  
Gastric Varices ◽  
Oesophageal Varices ◽  
Cyanoacrylate Glue ◽  
Back Ground ◽  
Successful Control ◽  
Glue Injection

Introduction: Rupture Gastric varices (GVs) can lead to catastrophic gastrointestinal bleeding, though it is much less in number than that of rupture oesophageal varices (OVs). Successful haemostasis of such bleeding is difficult specially in the back ground of non availability of appropriate drugs and instruments. Case Report: Introduction of intra-variceal injection of cyanoacrylate glue since 1980s has changed the scenario, it is cheaper and effective in controlling GVs related bleeding. A case of successful control of gastric variceal bleeding is reported. DOI: http://dx.doi.org/10.3329/jafmc.v7i2.10397 JAFMC 2011; 7(2): 44-46

scholarly journals A174 RARE BUT DEADLY: AN APPROACH TO MANAGEMENT OF DUODENAL VARICEAL HEMORRHAGE

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 39-41
Author(s):  
M Dahiya ◽  
M Tomaszewski ◽  
G Ou ◽  
A Ramji
Keyword(s):  
Interventional Radiology ◽  
Case Report ◽  
Portal Hypertension ◽  
Literature Review ◽  
Gastrointestinal Bleeding ◽  
Variceal Bleeding ◽  
Variceal Hemorrhage ◽  
Cyanoacrylate Glue ◽  
Duodenal Varices ◽  
Ectopic Varices

Abstract Background Common etiologies of upper gastrointestinal bleeding (UGIB) in cirrhotic patients with portal hypertension include gastroesophageal varices (GOV), portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE). Less commonly, patients with portal hypertension develop varices in ectopic sites, including the rectum, biliary tree and duodenum. Ectopic varices are rare, contributing to 1–5% of all variceal bleeding, of which 17% is from duodenal varices. Aims To describe the management of duodenal variceal hemorrhage. Methods A case report and literature review was performed. Results Case report: We present a case of recurrent UGIB in a 59-year-old male with decompensated cirrhosis due to non-alcoholic steatohepatitis (CP-C; Meld 14). Initial endoscopy was negative for GOV, peptic ulcer, PHG, and GAVE, but an erosion over a mucosal bulge in the third segment of the duodenum was identified, raising possibility of vascular malformation versus ectopic varix. There was active bleeding after water provocation, so clips were deployed for hemostasis. CT imaging showed mesenteric venous collaterals abutting the duodenum, again raising possibility of duodenal varix, which was ultimately confirmed by endoscopic ultrasound (EUS). Patient had recurrent overt bleeding despite beta-blockage for prophylaxis, endoscopic clipping on four separate occasions, attempted angioembolization by interventional radiology, and cyanoacrylate glue. Transjugular intrahepatic porto-systemic shunt (TIPS) was not possible due to portal vein occlusion, so he underwent EUS-guided cyanoacrylate glue a second time. Literature review: Ectopic varices are rare, contributing to 1–5% of all variceal bleeding, of which 17% is from duodenal varices. Duodenal variceal hemorrhage can lead to hemorrhagic shock, and is potentially life threatening, with quoted mortality rates of 40%. Unfortunately, duodenal varices can be difficult to identify. Diagnosis is often delayed due to a combination of lower awareness and endoscopic challenges given the unusual serosal and submucosal location. Evidence-based guidelines for the management of ectopic varices are limited. For this reason, our current management strategies rely heavily on local expertise. Splanchnic vasoconstrictor medication, endoscopic ligation, EUS guided gluing, interventional radiology guided embolization, TIPS, balloon retrograde transvenous obliteration and surgical shunts are potential therapeutic options to manage the acutely bleeding varix. Following a variceal bleed, liver transplantation should be considered in eligible patients with no other contraindications. Conclusions Duodenal varices are a rare, potentially fatal, and underrecognized cause of gastrointestinal bleeding in patients with portal hypertension. Definitive therapy currently relies upon local expertise in the absence of clear guideline-based therapy. Funding Agencies None

scholarly journals Non-cirrhotic portal hypertension: current concepts and modern management

2016 ◽  
Vol 43 (3) ◽  
pp. 170-176
Author(s):  
Md Ismail Patwary ◽  
Matiur Rahman ◽  
Kaushik Mojumder
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Variceal Bleeding ◽  
Gastric Varices ◽  
Idiopathic Portal Hypertension ◽  
Endoscopic Sclerotherapy ◽  
Cyanoacrylate Glue ◽  
Portal Fibrosis ◽  
Vascular Origin ◽  
Glue Injection

Non-cirrhotic portal hypertension (NCPH) is a heterogeneous group of liver disorders of vascular origin, leading to portal hypertension (PHTN) in the absence of cirrhosis.The lesions are generallyvascular, either in the portal vein, its branches or in the peri-sinusoidal area. The majority of diseases included in the category of NCPH are well-characterized disease entities where PHTN is a late manifestation. Two diseases that present only with features of PHTN and are common in developing countries are non-cirrhotic portal fibrosis (NCPF) and extrahepatic portal vein obstruction (EHPVO). Non-cirrhotic portal fibrosis is a syndrome of obscure etiology, characterized by ‘obliterative-portovenopathy’ leading to PHT, massive splenomegaly and well-tolerated episodes of variceal bleeding in young adults from low socioeconomic backgrounds, having near normal hepatic functions. In some parts of the world, NCPFis called idiopathic portal hypertension in Japan or ‘hepatoportalsclerosis’in USA. Because 85–95% of patient with NCPF and EHPVO present with variceal bleeding, treatment involves management with endoscopic sclerotherapy (EST) or variceal ligation (EVL). These therapies are effective in approximately 90–95% of patients. Gastric varices are another common cause of upper gastrointestinal bleeding in these patients and these can be managed with cyanoacrylate glue injection or surgery. The prognosis of patients with NCPF is good and 5 years survival in patients in whom variceal bleeding can be controlled has been reported to be approximately 95–100%.Bangladesh Med J. 2014 Sep; 43 (3): 170-176

scholarly journals Endoscopic ultrasound coil placement of gastric varices: Emerging modality for recurrent bleeding gastric varices

2014 ◽  
Vol 05 (01) ◽  
pp. 024-026
Author(s):  
Yogesh Harwani ◽  
Mahesh Kumar Goenka ◽  
Vijay Rai ◽  
Usha Goenka
Keyword(s):  
Case Report ◽  
Endoscopic Ultrasound ◽  
Standard Of Care ◽  
Gastric Varices ◽  
Recurrent Bleeding ◽  
High Complication Rate ◽  
Cyanoacrylate Glue ◽  
Acute Variceal Bleeding ◽  
Probable Source ◽  
Glue Injection

AbstractGastric varices are the probable source of bleeding in 10-36% of patients, with acute variceal bleeding and carry high mortality and rebleeding rates. Till date, cyanoacrylate glue injection is considered as the standard of care but has high complication rate. Endoscopic ultrasound (EUS) guided coil placement is a new emerging technique of management of gastric varices. In this case report, we detail the EUS guided coil placement for management of gastric varices after failed glue injections.

scholarly journals EUS-guided coil placement for acute gastric variceal bleeding induced by non-EUS-guided variceal glue injection (with video)

2019 ◽  
Vol 07 (03) ◽  
pp. E380-E383 ◽  
Author(s):  
Tarek Mazzawi ◽  
Carl Markhus ◽  
Roald Havre ◽  
Khanh Do-Cong Pham
Keyword(s):  
Case Report ◽  
Endoscopic Ultrasound ◽  
Variceal Bleeding ◽  
Gastric Varices ◽  
Acute Bleeding ◽  
Glue Injection ◽  
Video Case Report

Abstract Background and study aims Endoscopic ultrasound (EUS)-guided coil placement is a new emerging technique for management of gastric varices. In this video case report, we describe an EUS-guided coil placement for managing acute bleeding of gastric varices, following an unsuccessful glue injection to achieve hemostasis.

scholarly journals Histoacryl glue injection without lipiodol dilution and post sclerotherapy bleeding; prevalence among patients with upper GIT bleed.

2020 ◽  
Vol 27 (06) ◽  
pp. 1182-1186
Author(s):  
Muhammad Ayub ◽  
Sagheer Hussain ◽  
Salman Ahmed
Keyword(s):  
Liver Cirrhosis ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Gastric Varices ◽  
Recurrent Bleeding ◽  
Endoscopic Sclerotherapy ◽  
Ulcer Disease ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Glue Injection ◽  
Upper Gastrointestinal

Objectives: To determine role of histoacryl injection in preventing upper acute upper gastrointestinal bleeding. Study Design: Prospective Study. Setting: Gastroenterology ward of DHQ Teaching Hospital Gujranwala. Period: One year from 1st September 2017 to 31st August 2018. Material & Methods: Patients presented to the study hospital having upper gastrointestinal bleeding of acute onset due to gastric varices bleeding were included in this study. All other cases having upper GIT bleeding due to other causes like peptic ulcer disease, Mallory weise syndrome, gastritis or esophageal varices were not included in this study. Both male and female patients were included irrespective of their age. Hemostasis in these cases was achieved by endoscopic sclerotherapy using histoacryl glue (N-butyl-2-cyanoacrylate) injection without lipoidal dilution. After first session of injection patients were called on follow up after 5 days and they were assessed for recurrent GIT bleeding and treatment failure. All data was documented on a predesigned performa. Frequencies and percentage were calculated and results were expressed in tabular form and graphs. Results: Total 80 cases were studied including 56% male and 44% female cases. Endoscopic sclerotherapy using histoacryl injection proved successful in 87.5% cases and recurrent bleeding occurred in 12.5% cases. Minimum age of patients was 25 years and maximum age 70 years with mean age of 45 years. Total 450 cases presented in study institution with Upper GIT bleeding during study period and causes among them were liver cirrhosis in 92% cases, peptic ulcer disease in 4% cases, Malloryweise Syndrome in 2.5% and gastritis in 1.5% cases. In our study group cause of gastric varices was liver cirrhosis due to viral hepatitis in 73% cases and alcoholic hepatitis in 27% cases. After single session of endoscopic histoacryl glue injection to 80 cases, no bleeding occurred after 5 days in 71(88.7%) cases, recurrent bleeding occurred within 5 days in 9(11.2%) cases.  Two cases died due to massive recurrent bleeding and mortality rate was 2.5%. Conclusion: Endoscopic sclerotherapy using Histoacryl injection is very successful treatment for acute upper gastrointestinal bleeding with very low recurrence rate of bleeding and low mortality rate.

Treatment of Gastric Varices with 2-octyl-cyanoacrylate Glue Injection

2005 ◽  
Vol 100 ◽  
pp. S349-S350
Author(s):  
Ann M. Chen ◽  
Kenneth F. Binmoeller
Keyword(s):  
Gastric Varices ◽  
Cyanoacrylate Glue ◽  
Glue Injection

Emergency Endoscopy in Patients with Portal Hypertension Having Upper Gastrointestinal Bleeding

1997 ◽  
Vol 27 (1) ◽  
pp. 31-34
Author(s):  
S P Misra ◽  
M Dwivedi
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Gastric Varices ◽  
Oesophageal Varices ◽  
Endoscopic Sclerotherapy ◽  
Emergency Endoscopy ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal ◽  
Definite Role

During the last 4 years, 147 patients suffering from portal hypertension with acute upper gastrointestinal bleeding were subjected to emergency endoscopy soon after they were resuscitated. Seventeen (11.5%) patients were referred to us with a clinical diagnosis other than portal hypertension. The causes of bleeding as seen during endoscopy were: oesophageal varices ( n = 130; 88%), gastric varices ( n =11), gastric ulcer ( n = 2) portal hypertensive gastropathy ( n = 2) and erosive gastritis and duodenal ulcer in one patient each. All patient bleeding from oesophageal varices except one underwent emergency endoscopic sclerotherapy. One hundred and twenty-one (94%) stopped bleeding immediately. Rebleeding was seen in 11% and was effectively controlled by a second session of sclerotherapy in all but one patient. Twenty (14%) patients died. It is concluded that emergency endoscopy has a definite role in the management of patients with portal hypertension complicated by gastrointestinal bleeding.

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