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Life-threatening intraabdominal arterial embolization after histoacryl injection for bleeding gastric ulcer.

Authors
Lee, GH; Kim, JH; Lee, KJ; Yoo, BM; Hahm, KB; Cho, SW; Park, YS; Moon, YS
Citation
Endoscopy, 32(5):422-424, 2000
Journal Title
Endoscopy
ISSN
0013-726X1438-8812
Abstract
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.
MeSH terms
*Celiac ArteryEmbolism/*chemically induced/radiographyEmbolization, Therapeutic/*adverse effectsEnbucrilate/adverse effects/*analogs & derivativesGastroscopy*Hepatic ArteryHumansInjections, Intra-ArterialMaleMiddle AgedPeptic Ulcer Hemorrhage/pathology/*therapyStomach Ulcer/pathology/*therapyTissue Adhesives/*adverse effectsTomography, X-Ray Computed
DOI
10.1055/s-2000-9002
PMID
10817185
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
AJOU Authors
김, 진홍이, 광재유, 병무함, 기백조, 성원
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