Hémorragie digestive par expulsion de colle biologique après obturation endoscopique de varice gastrique: à propos d’un cas  <span class="so-article-trans-title" dir="auto"> Translated title: Gastrointestinal bleeding due to the expulsion of cyanoacrylate glue after endoscopic embolization of gastric varices: a case report </span>

Cheikhna, Fatimetou Zahra; Elgasmi, Nabila; Tahiri, Mohammed; Elrhaoussi, Fatima Zahra; Haddad, Fouad; Hliwa, Wafaa; Bellabah, Ahmed; Badre, Wafaa

doi:10.11604/pamj.2022.43.75.30034

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Hémorragie digestive par expulsion de colle biologique après obturation endoscopique de varice gastrique: à propos d’un cas Translated title: Gastrointestinal bleeding due to the expulsion of cyanoacrylate glue after endoscopic embolization of gastric varices: a case report

case-report

Author(s): Fatimetou Zahra Cheikhna ¹ ^, ^& ^, , Nabila Elgasmi ¹ , Mohammed Tahiri ¹ , Fatima Zahra Elrhaoussi ¹ , Fouad Haddad ¹ , Wafaa Hliwa ¹ , Ahmed Bellabah ¹ , Wafaa Badre ¹

Publication date (Electronic): 12 October 2022

Journal: The Pan African Medical Journal

Publisher: The African Field Epidemiology Network

Keywords: Hémorragie digestive haute, varice gastrique, hypertension portale, expulsion de colle biologique, cas clinique, Upper gastrointestinal bleeding, gastric varice, portal hypertension, expulsion of cyanoacrylate glue, case report

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Abstract

L´obturation des varices gastriques à la colle biologique est actuellement le traitement de choix des hémorragies digestives par rupture de varices gastriques. L´hémorragie digestive par expulsion de colle biologique après encollage des varices gastriques est une complication rare. Nous présentons une patiente de 65 ans suivie pour cirrhose, en décompensation sous traitement, ayant bénéficié d´une séance d´encollage biologique de varices gastriques 3 mois avant son admission pour hémorragie digestive haute; la fibroscopie œso-gastroduodénale (FOGD) a objectivé des varices œsophagiennes (VO) grade 2 avec une ulcération au sein d´une varice gastrique siège d´un saignement actif en rapport avec l´expulsion de colle biologique. La patiente a bénéficié d´une transfusion sanguine et mise sous sandostatine avec encollage biologique des GOV2 sans incident. L´hémorragie digestive après expulsion de colle biologique est une complication grave de l´encollage dont peu de cas ont été décrits dans la littérature nécessitant le plus souvent un geste endoscopique d´hémostase.

Translated abstract

Embolization of gastric varices with cyanoacrylate glue is the treatment of choice for digestive bleeding due to rupture of gastric varices. Gastrointestinal bleeding due to the expulsion of cyanoacrylate glue after gluing of gastric varices is a rare complication. We here report the case of a 65-year-old female patient on cirrhosis and decompensation treatment, undergoing cyanoacrylate glue of gastric varices 3 months before her admission for upper gastrointestinal bleeding; oesogastroduodenal fibroscopy objectified oesophageal varices grade 2 with ulcerated gastric varices and active bleeding due to the expulsion of cyanoacrylate glue. The patient received blood transfusion and sandostatin as well as cyanoacrylate gluing of GOV2 with no complications. Gastrointestinal bleeding after expulsion of cyanoacrylate glue is a serious complication of gluing. Few cases have been described in the literature that required, most often, endoscopic hemostasis.

Most cited references 22

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Low incidence of complications from endoscopic gastric variceal obturation with butyl cyanoacrylate.

Liu-Fang Cheng, Zhi-Qiang Wang, Chang-Zheng Li … (2010)

Endoscopic variceal obturation with tissue adhesive is used to control gastric variceal bleeding. We investigated the prevalence of serious complications from this therapy. We performed a retrospective analysis of complications that occurred in 753 patients with gastric variceal hemorrhages who were hospitalized in 2 tertiary referral hospitals. All patients received N-butyl-2-cyanoacrylate as therapy for endoscopic variceal obturation. Complications occurred in 51 patients. Thirty-three patients experienced rebleeding because of early-onset (within 3 months) extrusion of the N-butyl-2-cyanoacrylate glue cast (4.4%), 10 patients developed sepsis (1.3%), and 5 patients developed distant embolisms (0.7%; 1 pulmonary, 1 brain, and 3 splenic). One patient had major gastric variceal bleeding after endoscopic variceal obturation (0.1%), 1 developed a large gastric ulcer (0.1%), and 1 had mesentery hematoma, hemoperitoneum, and infection in the abdominal cavity (0.1%). The complication-related mortality was 0.53% (3 deaths from sepsis and 1 death from rebleeding after early-onset glue cast extrusion). The occurrence of complications after endoscopic variceal obturation with N-butyl-2-cyanoacrylate in gastric varices treatment is rare. Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.

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EUS-guided injection of cyanoacrylate in perforating feeding veins in gastric varices: results in 5 cases.

Rafael Romero-Castro, Francisco Pellicer-Bautista, Manuel Jimenez-Saenz … (2007)

Bleeding from gastric varices can be challenging because of its high mortality and recurrent bleeding rates. Endoscopic therapy with tissue adhesives can control acute hemorrhage, but recurrent bleeding could appear if obliteration is not achieved, and endoscopic vision could be troublesome in the case of massive hemorrhage. The glue injected could be responsible for embolic phenomena and local complications. EUS has proved useful in minimizing the risk of recurrent bleeding from gastric varices, accurately showing if they are obturated or not. The presence of perforating veins detected by EUS has been reported as a risk factor for recurrent bleeding from esophageal varices. To assess the efficacy of EUS-guided cyanoacrylate injection in gastric varices at the entrance of the perforating veins to obtain variceal obturation. Open-basis case series study. Tertiary care, academic medical center, Seville, Spain. Five consecutive patients with gastric varices were enrolled from May 2005 through May 2006. We injected cyanoacrylate-lipiodol in gastric varices with 22-gauge needles by EUS guidance. To analyze the obliteration of gastric varices, the recurrent bleeding rate, and safety of EUS-guided cyanoacrylate-lipiodol injection. EUS-guided injection of the perforating veins by using cyanoacrylate-lipiodol was successful in eradicating gastric varices in the 5 patients treated, without recurrent bleeding or other complications during the study follow-up. This is a single-center nonrandomized study. EUS-guided injection of cyanoacrylate at the level of the perforating veins in the treatment of gastric varices seems to be a safe, efficient, and accurate approach. Further controlled studies are warranted.

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Author and article information

Contributors

Fatima Zahra Elrhaoussi: https://orcid.org/0000-0003-4980-2787

Fouad Haddad: https://orcid.org/0000-0002-0286-5687

Wafaa Hliwa: https://orcid.org/0000-0003-2253-7602

Journal

Journal ID (nlm-ta): Pan Afr Med J

Journal ID (iso-abbrev): Pan Afr Med J

Journal ID (publisher-id): PAMJ

Title: The Pan African Medical Journal

Publisher: The African Field Epidemiology Network

ISSN (Electronic): 1937-8688

Publication date (Electronic): 12 October 2022

Publication date Collection: 2022

Volume: 43

Electronic Location Identifier: 75

Affiliations

[1 ]Service de Gastro-entérologie, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc

Author notes

[& ] Corresponding author: Fatimetou Zahra Cheikhna, Service de Gastro-entérologie, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc. zcheikhna02@ 123456gmail.com

Article

Publisher ID: PAMJ-43-75

DOI: 10.11604/pamj.2022.43.75.30034

PMC ID: 9789785

PubMed ID: 36590998

SO-VID: 46b68cbf-5c4a-4ee4-b05c-e52262dfe851

License:

The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.