Neurological symptoms and spinal cord embolism caused by endoscopic injection sclerotherapy for esophageal varices: A case report and literature review

Medicine (Baltimore). 2018 May;97(18):e0622. doi: 10.1097/MD.0000000000010622.

Abstract

Rationale: Spinal cord embolism is a rare complication of endoscopic injection sclerotherapy (EIS).

Patient concerns: We report a case of a 56-year-old man who presented neurological symptoms and spinal cord embolism caused by EIS on esophageal varices. Clinical signs and symptoms, laboratory tests, thoracic magnetic resonance imaging (MRI), and related treatment supported its diagnosis. DIAGNOSES:: spinal cord embolism.

Interventions: We stopped the hemostatic and anti-coagulation treatment, and switched to nerve nutrition, microcirculation, and hormone therapy, along with administering gastric mucosal protective agents.

Outcomes: The all patient's signs and symptoms and signs of spinal cord embolism were all relieved within 3 months after the clinical treatment.

Lessons: We recommend that neurological symptoms after EIS in patients with esophageal varices should be considered a rare complication. Life-threatening conditions could be avoided by an accurate and timely diagnosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Embolism / diagnosis
  • Embolism / etiology*
  • Embolism / therapy
  • Endoscopy / adverse effects*
  • Esophageal and Gastric Varices / therapy*
  • Humans
  • Hypesthesia / etiology
  • Injections / adverse effects
  • Lower Extremity
  • Male
  • Middle Aged
  • Muscle Weakness / etiology
  • Sclerosing Solutions / administration & dosage
  • Sclerotherapy / adverse effects*
  • Sclerotherapy / methods*
  • Spinal Cord / blood supply*

Substances

  • Sclerosing Solutions