Gut Liver.  2012 Jan;6(1):122-125.

Endoscopic Treatment of Duodenal Bleeding Caused by Direct Hepatocellular Carcinoma Invasion with an Ethanol Injection

• Kim JN
• Lee HS
• Kim SY
• Kim JH
• Jung SW
• Koo JS
• Yim HJ
• Lee SW
• Choi JH
• Kim CD
• Ryu HS

Abstract

We report a case of a man who developed duodenal bleeding caused by direct hepatocellular carcinoma (HCC) invasion, which was successfully treated with endoscopic ethanol injection. A 57-year-old man with known HCC was admitted for melena and exertional dyspnea. He had been diagnosed with inoperable HCC a year ago. Urgent esophagogastroduodenoscopy (EGD) showed two widely eroded mucosal lesions with irregularly shaped luminal protruding hard mass on the duodenal bulb. Argon plasma coagulation and Epinephrine injection failed to control bleeding. We injected ethanol via endoscopy to control bleeding two times with 14 cc and 15 cc separately without complication. Follow-up EGD catched a large ulcer with necrotic and sclerotic base but no bleeding evidence was present. He was discharged and he did relatively well during the following periods. In conclusion, Endoscopic ethanol injection can be used as a significantly effective and safe therapeutic tool in gastrointestinal tract bleeding caused by HCC invasion.

Keyword

Endoscopic treatment; Ethanol injection; Duodenal bleeding; Hepatocellular carcinoma

MeSH Terms

Argon Plasma Coagulation
Carcinoma, Hepatocellular
Cytochrome P-450 CYP1A1
Dyspnea
Endoscopy
Endoscopy, Digestive System
Epinephrine
Ethanol
Follow-Up Studies
Gastrointestinal Tract
Hemorrhage
Humans
Melena
Middle Aged
Phenobarbital
Ulcer
Cytochrome P-450 CYP1A1
Epinephrine
Ethanol
Phenobarbital