Endoscopy 2007; 39: E242
DOI: 10.1055/s-2007-966832
Unusual cases and technical notes

© Georg Thieme Verlag KG Stuttgart · New York

Sclerosant extravasation following endoscopic injection sclerotherapy for bleeding gastric varices

K.  Akimoto1 , M.  Inamori1 , T.  Akiyama1 , H.  Endo1 , K.  Fujita1 , M.  Yoneda1 , H.  Takahashi1 , A.  Goto1 , Y.  Abe1 , H.  Kirikoshi1 , N.  Kobayashi1 , K.  Kubota1 , S.  Saito1 , N.  Ueno1 , A.  Nakajima1
  • 1Gastroenterology Division, Yokohama City University School of Medicine, Japan
Further Information

Publication History

Publication Date:
24 October 2007 (online)

A 71-year-old woman was admitted to our hospital because of vomiting blood, and an endoscopic examination revealed ruptured gastric varices ([Fig. 1]). Endoscopic injection sclerotherapy was carried out by injecting a total of 2 mL of sclerosant (a mixture of 1 mL of cyanoacrylate and the same amount of lipiodol) into the varices ([Fig. 2]), and endoscopic hemostasis was achieved ([Fig. 3]).

Immediately after the procedure, the patient complained of left upper quadrant pain, and she was treated with an analgesic. Radiograph and computed tomography ([Fig. 4 a, b]) revealed a high-density area around the left diaphragm, and we made a diagnosis of extravasation of the sclerosant following sclerotherapy. The symptoms resolved 1 day after the procedure.

Only one previous report has focused on extravasation following sclerotherapy for bleeding gastric varices. Cheng et al. reported a case of intraperitoneal sclerosant leakage after sclerotherapy with a 3 mL mixture of cyanoacrylate and lipiodol [1]. Sclerosant extravasation following sclerotherapy for gastric varices is a very rare but serious complication.

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Fig. 1 Bleeding from gastric varices was revealed.

Fig. 2 Endoscopic injection sclerotherapy was carried out.

Fig. 3 Endoscopic hemostasis was successful.

Fig. 4 a, b A computed tomography scan revealed a high-density area around the left diaphragm.

References

M. Inamori, MD

Gastroenterology Division
Yokohama City University School of Medicine

3-9 Fukuura
Kanazawa-ku
Yokohama 236-0004
Japan

Fax: +81-45-784-3546

Email: Email: inamorim@med.yokohama-cu.ac.jp