Successful treatment of persistent bacteremia after endoscopic injection of N-butyl-2-cyanoacrylate for gastric varices bleeding

Abstract

− late has been used successfully for the he− mostatic treatment of bleeding gastric varices [1]. Various complications asso− ciated with the procedure have been re− ported [2]. The prevalence of infectious complications could range from 4.3 % to 50 %, and most are transient and unevent− ful [3]. Because prolonged and persistent septic complications have been rarely re− ported, the appropriate strategy of man−

Detection of an Infected N-butyl-2-cyanoacrylate Plug by F-18 FDG PET/CT Scan in a Patient Who Received Endoscopic Intervention for Gastric Variceal Bleeding

“…This paper reports that FDG PET/CT clearly showed an abnormal hypermetabolic lesion around the N-butyl-2-cyanoacrylate plug with improvement after treatment with antibiotics and finally diagnosing the site of infection. Liao SC et al reported on a case in which gallium-67 scan was used in identification of the infection site [7] and Wahl P et al reported on a case in which gastroscopy along with abdomen CT postulated the source of infection [8]. In a study on FUO patients who underwent both FDG PET and Ga scintigrahy, Blockmans et al [9] found that FDG PET showed more abnormalities than Ga scintigraphy (77% vs 67% respectively).…”

Recurrent Bacteremia, a Complication of Cyanoacrylate Injection for Variceal Bleeding: Report of Two Cases and Review of the Literature

“…The frequency of this complication is unknown but remains probably low. Only few cases have been described in literature [2, 4]. Bacteremia is generally transient without clinical consequences.…”

“…As probably reported in the first case and in the literature, the communication between the gastrointestinal lumen and the vascular spaces leads to recurrent bacteremia [2, 4]. Another well-known complication is a glue embolization [9].…”

“…This bacteremia is usually transient involving oral or digestive pathogens [2]. As opposed to these transient episodes, recurrent bacteremia is not frequently encountered [2, 4]. We here report two cases of recurrent bacteremia with septic complications after variceal cyanoacrylate injection.…”

Gluing Gastric Varices in 2012: Lessons Learnt Over 25 Years

“…75 A few reports have described recurrent bacteremia from an infected glue conglomerate in the GV this has been successfully treated with repeated courses of antibiotics. 76,77 A recent report described GVO complicated by pyogenic spleno-portal thrombosis which led to persistent Klebsiella pneumoniae septicemia. The glue plug is a foreign body that offers an ideal surface for bacterial colonization and becomes a reservoir for continuous bacterial dissemination.…”