[Esophageal sinus formation due to cyanoacrylate injection for esophageal variceal ligation-induced ulcer bleeding in a cirrhotic patient].

Publisher: Korean Society of Gastroenterology Country of Publication: Korea (South) NLM ID: 101189416 Publication Model: Print Cited Medium: Internet ISSN: 2233-6869 (Electronic) Linking ISSN: 15989992 NLM ISO Abbreviation: Korean J Gastroenterol Subsets: MEDLINE

Original Publication: Seoul, Korea : Korean Society of Gastroenterology, [2003]-

Embolization, Therapeutic*; Cyanoacrylates/*adverse effects ; Esophageal and Gastric Varices/*diagnosis ; Gastrointestinal Hemorrhage/*therapy ; Liver Cirrhosis, Alcoholic/*complications ; Tissue Adhesives/*adverse effects ; Ulcer/*complications; Cyanoacrylates/administration & dosage ; Endoscopy, Digestive System ; Esophageal and Gastric Varices/complications ; Esophageal and Gastric Varices/therapy ; Esophagus/diagnostic imaging ; Ethiodized Oil/therapeutic use ; Gastrointestinal Hemorrhage/surgery ; Humans ; Ligation ; Liver Cirrhosis, Alcoholic/diagnosis ; Male ; Middle Aged ; Radiography ; Tissue Adhesives/administration & dosage ; Ultrasonography

Intravariceal injection of N-butyl-2-cyanoacrylate is widely used for the hemostasis of bleeding gastric varices, but not routinely for esophageal variceal hemorrhage because of various complications such as pyrexia, bacteremia, deep ulceration, and pulmonary embolization. We report a rare case of esophageal sinus formation after cyanoacrylate obliteration therapy for uncontrolled bleeding from post-endoscopic variceal ligation (EVL) ulcer. A 50-year-old man with alcoholic liver cirrhosis presented with hematemesis. Emergent esophagogastroscopy revealed bleeding from large esophageal varices with ruptured erosion, and bleeding was initially controlled by EVL, but rebleeding from the post-EVL ulcer occurred at 17th day later. Although we tried again EVL and the injections of 5% ethanolamine oleate at paraesophageal varices, bleeding was not controlled. Therefore, we administered 1 mL cyanoacrylate diluted with lipiodol and bleeding was controlled. Three months after the endoscopic therapy, follow-up endoscopy showed medium to large-sized esophageal varices and sinus at lower esophagus. Barium esophagography revealed an outpouching in esophageal wall and endoscopic ultrasonography demonstrated an ostium with sinus. It is noteworthy that esophageal sinus can be developed as a rare late complication of endoscopic cyanoacrylate obliteration therapy.

0 (Cyanoacrylates)
0 (Tissue Adhesives)
8008-53-5 (Ethiodized Oil)

Date Created: 20110427 Date Completed: 20110816 Latest Revision: 20170309

20240829

10.4166/2011.57.3.180

21519166