Korean J Gastrointest Endosc.  1999 Feb;19(1):59-66.

A Case of Pulmonary Embolism Induced by Complication of Histoacryl Injection Therapy in Gastric Varix Bleeding

• Song CW
• Park TW
• Kim TY
• Lee DS
• Kim SW
• Byun BH
• Choi JY
• Yang YS
• Chung IS
• Park DH
• Kim BS

Abstract

N-Butyl-2-cyanoacrylate (Histoacryl) has been used successfully to control bleeding from esophagogastric varices since the first report in 1986 by Soehendra. Complications of Histoacryl injection include local sloughing with ulcer formation, rebleeding, sepsis, mediastinitis, esophageal strictures and fever. Systemic embolization, including pulmonary and cerebral embolization, has been reported. We describe here the presentation of an un-usual complication of Histoacryl injection. A 42-year-old woman presented with an attack of massive hematemesis. Endoscopy revealed bleeding evidence of gastric varices. Sclero-therapy was carried out using Histoacryl mixed with Lipiodol (ratio 1 : 1), with complete solidification of the varix. Next morning she complained of dyspnea and tachycardia. The chest x-ray showed multiple metallic densities, consistent with cyanoacrylate mixed with lipoidol, located at central portion. She was diagnosed as having pulmonary embolism by convential precontrast chest CT. She was treated conservatively using oxygen and analge-sics. She recovered soon and was discharged without significant problems.

Keyword

Gastric varix; Cyanoacrylate; Pulmonary embolism

MeSH Terms

Adult
Constriction, Pathologic
Cyanoacrylates
Dyspnea
Enbucrilate*
Endoscopy
Esophageal and Gastric Varices*
Ethiodized Oil
Female
Fever
Hematemesis
Hemorrhage*
Humans
Mediastinitis
Oxygen
Pulmonary Embolism*
Sepsis
Tachycardia
Thorax
Tomography, X-Ray Computed
Ulcer
Varicose Veins
Cyanoacrylates
Enbucrilate
Ethiodized Oil
Oxygen