Endoscopic injection sclerotherapy with n-butyl-2-cyanoacrylate for ruptured duodenal varices

K, Ota; Shirai, Zentaro; Masuzaki, Takao; Tanaka, Keiichi; Higashihara, Hideyuki; Okazaki, Masanori; Arakawa, Masahiro

doi:10.1007/s005350050131

Cited by 44 publications

(32 citation statements)

References 22 publications

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“…Surgical adhesives are increasingly being used in soft tissue repair as fasteners and sealants because they can be applied easily without physically injuring the tissue [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. An ideal adhesive would adhere rapidly to the tissue substrate and provide adequate strength to the joint under physiological conditions while enabling the wound to heal.…”

Section: Introductionmentioning

confidence: 99%

Adhesive strength and curing rate of marine mussel protein extracts on porcine small intestinal submucosa

et al. 2007

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An adhesive protein extracted from marine mussel (Mytilus edulis) was used to bond strips of connective tissue for the purpose of evaluating the use of curing agents to improve adhesive curing. Specifically, mussel adhesive protein solution (MAPS, 0.5 mM dihydroxyphenylalanine) was applied, with or without the curing agents, to the ends of two overlapping strips of porcine small intestinal submucosa. The bond strength of this lap joint was determined after curing for 1 h at room temperature (25°C). The strength of joints formed using only MAPS or with only the ethyl, butyl or octyl cyanoacrylate adhesives were determined. Although joints bonded using ethyl cyanoacrylate were strongest, those using MAPS were stronger than those using butyl and octyl cyanoacrylates. The addition of 25 mM solutions of the transition metal ions V 5+ , Fe 3+ and Cr 6+ , which are all oxidants, increased the bond strength of the MAPS joints. The V 5+ gave the strongest bonds and the Fe 3+ the second strongest. In subsequent tests with V 5+ and Fe 3+ solutions, the bond strength increased with V 5+ concentration, but it did not increase with Fe 3+ concentration. Addition of 250 mM V 5+ gave a very strong bond.

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Section: Introductionmentioning

confidence: 99%

Adhesive strength and curing rate of marine mussel protein extracts on porcine small intestinal submucosa

et al. 2007

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“…13,14 However, duodenal varices in the distal third portion are rare. 15,16 Precise diagnosis of the site of bleeding in the duodenum is diffi cult. In the case discussed here, because duodenal varices were not revealed by endoscopic examination of the upper gastrointestinal tract, we considered the possibility of rupture of duodenal varices after reviewing the results of CT examination.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of color Doppler ultrasonography for the diagnosis of duodenal varices successfully treated with percutaneous transhepatic obliteration

et al. 2007

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We treated a 74-year-old woman who complained of tarry stool. Neither endoscopic examination of the upper gastrointestinal tract nor colonoscopy revealed any finding indicative of bleeding, and (99m)Tc-HSA-D pool scintigraphic imaging showed no accumulation of blood in the digestive tract. Small tortuous collateral veins were observed on computed tomography (CT) in the distal third portion of the duodenum. Color Doppler ultrasonography obtained color flow images of varices in the distal third portion of the duodenum indicating turbulent flow, and color flow imaging showed the outflow vessel from duodenal varices. Duodenoscopy revealed tortuous varices, with erosions and blue in appearance, in the same area. Percutaneous transhepatic portography was carried out 18 days after the treatment of ascites, and hepatofugal blood flow was confirmed in the pancreatic duodenal vein originating near the junction between the splenic and inferior mesenteric veins with the passage of contrast medium into the duodenal varices, which drained into the left ovarian vein. We performed selective catheterization into the afferent vein of the varices, and injected 8 ml of a 5% solution of ethanolamine oleate containing iopamidol. Microcoil embolization using steel coils was added because the therapeutic effect resulting after the relatively rapid washout of sclerosant was insufficient. CT and color Doppler ultrasonography showed absence of blood flow in the varices 1 week after the therapy. This patient has had no episodes of rebleeding in the 24 months after therapy. Color Doppler ultrasonography was useful in diagnosing this case of duodenal varices and in evaluating therapeutic effect.

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“…Histoacryl is injected inside the varices, polymerizes at once and causes embolization. Because Histoacryl bring about an inflammatory reaction and stimulates fibrotic changes in the ulcer [2]. EIS with Histoacryl is accepted to be useful for treating duodenal varices.…”

Section: Discussionmentioning

confidence: 99%

An unusual cause of upper gastrointestinal system bleeding: Duodenal varices

Yılmaz¹,

Ataseven²

2012

CMJ

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Duodenal varices are an uncommon site of hemorrhage in patients with portal hypertension, but their rupture is a serious and often fatal event. We report the case of a 27-year-old man with liver cirrhosis who presented with upper gastrointestinal bleeding. Upper gastrointestinal endoscopy revealed nodular varices in the second portion of the duodenum which were considered to be the source of bleeding. We decided to inject N-butyl-2-cyanoacrylate (Histoacryl), an adhesive agent, and achieved successful hemostasis. We conclude that endoscopic injection sclerotherapy (EIS) with Histoacryl is an effective treatment option for ruptured duodenal varices.

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Endoscopic injection sclerotherapy with n-butyl-2-cyanoacrylate for ruptured duodenal varices

Cited by 44 publications

References 22 publications

Adhesive strength and curing rate of marine mussel protein extracts on porcine small intestinal submucosa

Adhesive strength and curing rate of marine mussel protein extracts on porcine small intestinal submucosa

Efficacy of color Doppler ultrasonography for the diagnosis of duodenal varices successfully treated with percutaneous transhepatic obliteration

An unusual cause of upper gastrointestinal system bleeding: Duodenal varices

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