Pulmonary, Cerebral and Coronary Emboli During Bucrylate Injection of Bleeding Fundic Varices

Roêsch, W.; Rexroth, G

doi:10.1055/s-2007-1001406

Cited by 59 publications

(43 citation statements)

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“…Among the case reports on systemic Histoacryl embolism, echocardiographic study showed either patent foramen ovale [7,9] or no evidence of intracardiac shunt [8,18]. Other authors did not report on echocardiographic findings and have presumed that the paradoxical embolization occurred via an arteriovenous pulmonary shunt [16,17].…”

Section: Discussionmentioning

confidence: 99%

“…In these six case series, which include 1,022 episodes of gastric varices injections, there was only one case of cerebral embolism [1]. In addition, there are three case reports on cerebral embolism associated with Histoacryl injection for gastric varices [7][8][9]. Table 2 summarizes the three case reports [7][8][9] on cerebral embolism following Histoacryl-lipiodol injection for gastric varices.…”

Section: Introductionmentioning

confidence: 99%

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Cerebral embolism following N-butyl-2-cyanoacrylate injection for esophageal postbanding ulcer bleed: a case report

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cerebral embolism following N-butyl-2-cyanoacrylate injection for esophageal postbanding ulcer bleed: a case report

et al. 2009

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“…Cyanoacrylate polymerizes immediately on contact with blood, resulting in rapid hemostasis. Major complications of the procedure include ulceration and recurrent bleeding, although more serious complications, including embolization to the brain [46], portal vein [47], lung [48,49], and spleen [50,51] have also been reported. Other complications include bacteremia [52] and abscesses [53].…”

Section: Treatments Of Gastric Varices Secondary To Left-sided Portalmentioning

confidence: 99%

Gastric Varices Secondary to Splenic Vein Occlusion due to Pancreatic Diseases

Kimura¹

2013

Pancreat Disord Ther

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Sato et al., Pancreatic Dis Ther 2013, S3 http://dx.doi.org/10.4172/2165 Gastric Varices Secondary to Splenic Vein Occlusion due to Pancreatic Diseases Takahiro Sato*, Sho Kitagawa, Mutsuumi Kimura, Takumi Ohmura, Yoshiyasu Karino and Jouji Toyota Department of Gastroenterology, Sapporo Kosei General Hospital, Japan occlusion because of the splenic vein, s anatomy. Sutton et al. reported that 35% of their cases of isolated splenic vein occlusion were caused by tumors and only 17% by pancreatitis [9]. On the other hand, Sakorafas et al. found that pancreatitis was the etiology in 87 (60%) of 144 cases, while pancreatic malignancy was detected in only [13] (9%) of the patients [7], and recent reviews have clarified acute or chronic pancreatitis to be the probable cause of splenic vein thrombosis in the majority of cases [18]. There is a possible pathogenetic mechanism implying the increased intra-abdominal pressure leading to compression of the splenic vein in the case of pancreatic pseudocyst [19,20].Due to splenic vein occlusion, splenic venous flow must drain into collateral veins (short gastric vein and left gastroepiploic vein). Then, the increased blood flow dilates the submucosal veins of stomach, resulting in gastric varices (Figure 1). Because blood drainage is diverted by the coronary vein into the patent portal system, the presence of gastric varices without esophageal varices is a very specific sign of splenic vein occlusion [17]. This condition, which is commonly silent clinically, can cause hypersplenism or gastrointestinal hemorrhage.Although splenic vein occlusion is commonly silent clinically, AbstractGastric varices that arise secondary to splenic vein occlusion can result in hypersplenism or gastrointestinal hemorrhaging. This article review gastric varices secondary to splenic vein occlusion due to pancreatic diseases with regard to causes of the condition, as well as diagnostic and therapeutic approaches.Diagnosis of gastric varices is made following esophago-gastro-duodenoscopy, and splenic vein occlusions are diagnosed from enhanced computed tomographic scans in almost all cases. Specific findings of gastric varices secondary to splenic vein occlusion are based on endoscopic ultrasonographic color flow images of gastric variceal flow that clearly depicted round cardiac and fundal regions at the center, with varices expanding to the curvatura ventriculi major of the gastric body.Several treatment options for gastric variceal bleeding secondary to splenic vein occlusion have been proposed. Splenectomy, which decompresses the short gastric vein by cutting off inflow, has generally been considered the best treatment of choice in such condition. Endoscopic injection sclerotherapy using cyanoacrylate, is useful in the treatment of bleeding gastric varices due to splenic vein occlusion. As patients with splenic vein occlusion have normal portal pressure and normal hepatic function, portal systemic shunting is not indicated. Splenic arterial embolization, which reduces blood flow through the sp...

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“…Pulmonary, cerebral and coronary emboli may occur during cyanoacrylate injection of gastric varices [87,88]. On current evidence, the use of EIS or VBL alone is not justified for primary prophylaxis against gastric variceal bleeding because there are issues of safety related to the use of both these procedures.…”

Section: Recommendationsmentioning

confidence: 99%

Primary prophylaxis of gastroesophageal variceal bleeding: consensus recommendations of the Asian Pacific Association for the Study of the Liver

et al. 2008

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The Asian Pacific Association for the Study of the Liver (APASL) set up a Working Party on Portal Hypertension in 2002, with a mandate to develop consensus guidelines on various clinical aspects of portal hypertension relevant to disease patterns and clinical practice in the Asia-Pacific region. Variceal bleeding is a consequence of portal hypertension, which, in turn, is the major complication of liver cirrhosis. Primary prophylaxis to prevent the first bleed from varices is one of the most important strategies for reducing the mortality in cirrhotic patients. Experts predominantly from the Asia-Pacific region were requested to identify the different aspects of primary prophylaxis and develop the consensus guidelines. The APASL Working Party on Portal Hypertension evaluated the various therapies that have been used for the prevention of first variceal bleeding. A 2-day meeting was held on January 12 and 13, 2007, at New Delhi, India, to discuss and finalize the consensus statements. Only those statements that were unanimously approved by the experts were accepted. These statements were circulated to all the experts and were subsequently presented at the annual conference of the APASL at Kyoto, Japan, in March 2007.

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Pulmonary, Cerebral and Coronary Emboli During Bucrylate Injection of Bleeding Fundic Varices

Cited by 59 publications

References 0 publications

Cerebral embolism following N-butyl-2-cyanoacrylate injection for esophageal postbanding ulcer bleed: a case report

Cerebral embolism following N-butyl-2-cyanoacrylate injection for esophageal postbanding ulcer bleed: a case report

Gastric Varices Secondary to Splenic Vein Occlusion due to Pancreatic Diseases

Primary prophylaxis of gastroesophageal variceal bleeding: consensus recommendations of the Asian Pacific Association for the Study of the Liver

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