Endoscopic Treatment of Esophageal Varices: Combination of Endoscopic Variceal Ligation and Endoscopic Injection Sclerotherapy

Yamamoto, Manabu; Suzuki, Hiroaki

doi:10.1007/978-981-10-7425-7_30

Cited by 1 publication

(1 citation statement)

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“…Since then, derivatives that are less harmful to the human body have been produced; after the 1970 s, N-butyl-2-cyanocrylate (Histoacryl), which is known to have the least tissue inflammatory action, has been used most commonly. [8] In the 1980 s, it was first introduced for endoscopic hemostasis of variceal bleeding. The effect and safety of N-butyl-2-cyanocrylate in gastrointestinal fistula has also been proven in several reports.…”

Section: Discussionmentioning

confidence: 99%

Cyanoacrylate injection treatment for postoperative leakage of Boerhaave's syndrome

Park

Yum²,

Myung³

2021

Medicine

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Rationale: Surgical treatment remains the most effective option for treating Boerhaave's syndrome. However, in cases of postoperative anastomotic leakage of Boerhaave's syndrome, endoscopic interventions such as over-the-scope clip, stenting, or cyanoacrylate injection have emerged over reoperation. Patient concerns: We report the case of a 50-year-old male patient who presented with vomiting and abdominal pain after alcohol consumption. Laparoscopic surgery was performed for primary closure of a laceration at the lower esophagus, and for the closure of a Boerhaave's syndrome, which was detected by abdominal computed tomography. However, postoperative anastomotic leakage was confirmed through esophagography after the operation. In our case, endoscopic treatment with an over-the-scope clip and stenting were not effective for the repair of the anastomotic leakage, but cyanoacrylate injection successfully healed the anastomotic leakage. Diagnoses: Boerhaave's syndrome was initially detected by abdominal computed tomography, but postoperative anastomotic leakage after the operation was confirmed with esophagography. Interventions: A total of 2.0 cc of N-butyl-2-cyanoacrylate and lipiodol mixture (at 1:1) was injected into the leakage tract through the perforation entrance. Outcomes: Complete healing of the anastomotic leakage was confirmed with a follow-up esophagoscopy. Lessons: N-butyl-2-cyanocrylate injection treatment can be used as a rescue option for postoperative leakage when over-the-scope clips and stenting fail for this indication.

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Section: Discussionmentioning

confidence: 99%