Gastric ischemia after epinephrine injection in a patient with liver cirrhosis

World J Gastroenterol. 2013 Jan 21;19(3):411-4. doi: 10.3748/wjg.v19.i3.411.

Abstract

Endoscopic epinephrine injection is relatively easy, quick and inexpensive. Furthermore, it has a low rate of complications, and it is widely used for the management of nonvariceal upper gastrointestinal bleeding. There have been several case reports of gastric ischemia after endoscopic injection therapy. Inadvertent intra-arterial injection may result in either spasm or thrombosis, leading to subsequent tissue ischemia or necrosis, although the stomach has a rich vascular supply and the vascular reserve of the intramural anastomosis. In addition to endoscopic injection therapy, smoking, hypertension and atherosclerosis are risk factors of gastric ischemia. We report a case of gastric ischemia after submucosal epinephrine injection in a 51-year-old woman with hypertension and liver cirrhosis.

Keywords: Epinephrine; Gastric ischemia; Hematemesis; Hypertension; Liver cirrhosis.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Comorbidity
  • Endoscopy, Digestive System / adverse effects
  • Epinephrine / administration & dosage
  • Epinephrine / adverse effects*
  • Epinephrine / therapeutic use
  • Female
  • Gastrointestinal Hemorrhage / prevention & control
  • Humans
  • Hypertension / epidemiology
  • Injections
  • Ischemia / diagnosis*
  • Ischemia / etiology*
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / epidemiology
  • Middle Aged
  • Necrosis / pathology
  • Stomach / blood supply*
  • Stomach / pathology
  • Treatment Outcome
  • Vasoconstrictor Agents / administration & dosage
  • Vasoconstrictor Agents / adverse effects*
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents
  • Epinephrine