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Bleeding from a duodenal varix: a unique case of variceal hemostasis achieved using EUS-guided placement of an embolization coil and cyanoacrylate.
J Clin Gastroenterol. 2014 Apr; 48(4):362-4.JC

Abstract

We report a case of a bleeding duodenal varix demonstrating excellent hemostasis achieved by endoscopic ultrasound (EUS)-directed placement of an embolization coil followed by cyanoacrylate. A 31-year-old man with decompensated Child's class C cirrhosis presented with hematemesis. An initial endoscopy revealed an actively bleeding duodenal varix. Subsequent attempt at hemostasis with ethanolamine oleate injection failed. A later attempt at hemostasis involving EUS-guided placement of an embolization coil followed by cyanoacrylate injection into the varix was successful. We reviewed the literature involving the treatment of bleeding ectopic varices and conclude that EUS provides a unique and advantageous modality for achieving variceal hemostasis of duodenal varices in patients who are not candidates for transjugular intrahepatic portosystemic shunt.

Authors+Show Affiliations

Yale University School of Medicine-Yale New Haven Hospital, New Haven, CT.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

24518801

Citation

Kinzel, Jason, et al. "Bleeding From a Duodenal Varix: a Unique Case of Variceal Hemostasis Achieved Using EUS-guided Placement of an Embolization Coil and Cyanoacrylate." Journal of Clinical Gastroenterology, vol. 48, no. 4, 2014, pp. 362-4.
Kinzel J, Pichetshote N, Dredar S, et al. Bleeding from a duodenal varix: a unique case of variceal hemostasis achieved using EUS-guided placement of an embolization coil and cyanoacrylate. J Clin Gastroenterol. 2014;48(4):362-4.
Kinzel, J., Pichetshote, N., Dredar, S., Aslanian, H., & Nagar, A. (2014). Bleeding from a duodenal varix: a unique case of variceal hemostasis achieved using EUS-guided placement of an embolization coil and cyanoacrylate. Journal of Clinical Gastroenterology, 48(4), 362-4. https://doi.org/10.1097/MCG.0000000000000004
Kinzel J, et al. Bleeding From a Duodenal Varix: a Unique Case of Variceal Hemostasis Achieved Using EUS-guided Placement of an Embolization Coil and Cyanoacrylate. J Clin Gastroenterol. 2014;48(4):362-4. PubMed PMID: 24518801.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bleeding from a duodenal varix: a unique case of variceal hemostasis achieved using EUS-guided placement of an embolization coil and cyanoacrylate. AU - Kinzel,Jason, AU - Pichetshote,Nipaporn, AU - Dredar,Serag, AU - Aslanian,Harry, AU - Nagar,Anil, PY - 2014/2/13/entrez PY - 2014/2/13/pubmed PY - 2014/11/7/medline SP - 362 EP - 4 JF - Journal of clinical gastroenterology JO - J Clin Gastroenterol VL - 48 IS - 4 N2 - We report a case of a bleeding duodenal varix demonstrating excellent hemostasis achieved by endoscopic ultrasound (EUS)-directed placement of an embolization coil followed by cyanoacrylate. A 31-year-old man with decompensated Child's class C cirrhosis presented with hematemesis. An initial endoscopy revealed an actively bleeding duodenal varix. Subsequent attempt at hemostasis with ethanolamine oleate injection failed. A later attempt at hemostasis involving EUS-guided placement of an embolization coil followed by cyanoacrylate injection into the varix was successful. We reviewed the literature involving the treatment of bleeding ectopic varices and conclude that EUS provides a unique and advantageous modality for achieving variceal hemostasis of duodenal varices in patients who are not candidates for transjugular intrahepatic portosystemic shunt. SN - 1539-2031 UR - https://www.unboundmedicine.com/medline/citation/24518801/Bleeding_from_a_duodenal_varix:_a_unique_case_of_variceal_hemostasis_achieved_using_EUS_guided_placement_of_an_embolization_coil_and_cyanoacrylate_ L2 - https://doi.org/10.1097/MCG.0000000000000004 DB - PRIME DP - Unbound Medicine ER -