[Fundal variceal bleeding treated with balloon occluded endoscopic inyection sclerotherapy. Report of two cases]

Rev Med Chil. 2017 Oct;145(10):1336-1341. doi: 10.4067/S0034-98872017001001336.
[Article in Spanish]

Abstract

Management of gastrointestinal bleeding caused by fundal varices is particularly difficult to manage. The options are: transjugular intrahepatic portosystemic shunt (TIPS), endoscopic injection of cyanoacrylate or balloon-occluded retrograde transvenous obliteration (BRTO). We report a 63 year-old male with a cirrhosis caused by hepatitis C and a 66 year-old female with a cirrhosis caused by a non-alcoholic steatohepatitis. Both patients had a gastrointestinal bleeding caused by fundal varices and were treated with sclerotherapy with cyanoacrylate assisted with BRTO. Flow was interrupted in the gastro-renal shunt by a femoral access in both patients. The male patient had a new bleeding two months later and died. In the female patient an endosonography performed nine months after the procedure showed absence of remaining varices.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Balloon Occlusion / methods*
  • Cyanoacrylates / therapeutic use*
  • Esophageal and Gastric Varices / complications
  • Esophageal and Gastric Varices / therapy*
  • Fatal Outcome
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy*
  • Humans
  • Liver Cirrhosis / complications
  • Male
  • Middle Aged
  • Portacaval Shunt, Surgical
  • Portal Vein
  • Reproducibility of Results
  • Sclerotherapy / methods*
  • Treatment Outcome

Substances

  • Cyanoacrylates