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Endoscopic cyanoacrylate injection for the treatment of gastric varices in children.
World J Gastroenterol. 2015 Mar 07; 21(9):2719-24.WJ

Abstract

AIM

To evaluate the efficacy and safety of N-butyl-2-cyanoacrylate in treating acute bleeding of gastric varices in children.

METHODS

The retrospective study included 21 children with 47 episodes of active gastric variceal bleeding who were treated by endoscopic injection of N-butyl-2-cyanoacrylate at Asan Medical Center Children's Hospital between August 2004 and December 2011. To reduce the risk of embolism, each injection consisted of 0.1-0.5 mL of 0.5 mL N-butyl-2-cyanoacrylate diluted with 0.5 or 0.8 mL Lipiodol. The primary outcome was incidence of hemostasis after variceal obliteration and the secondary outcome was complication of the procedure.

RESULTS

The 21 patients experienced 47 episodes of active gastric variceal bleeding, including rebleeding, for which they received a total of 52 cyanoacrylate injections. Following 42 bleeding episodes, hemostasis was achieved after one injection and following five bleeding episodes it was achieved after two injections. The mean volume of each single aliquot of cyanoacrylate injected was 0.3 ± 0.1 mL (range: 0.1-0.5 mL). Injection achieved hemostasis in 45 of 47 (95.7%) episodes of acute gastric variceal bleeding. Eleven patients (52.4%) developed rebleeding events, with the mean duration of hemostasis being 11.1 ± 11.6 mo (range: 1.0-39.2 mo). No treatment-related complications such as distal embolism were noted with the exception of abdominal pain in one patient (4.8%). Among four mortalities, one patient died of variceal rebleeding.

CONCLUSION

Endoscopic variceal obliteration using a small volume of aliquots with repeated cyanoacrylate injection was an effective and safe option for the treatment of gastric varices in children.

Authors+Show Affiliations

Seak Hee Oh, Seung Jin Kim, Kang Won Rhee, Kyung Mo Kim, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul 138-736, South Korea.Seak Hee Oh, Seung Jin Kim, Kang Won Rhee, Kyung Mo Kim, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul 138-736, South Korea.Seak Hee Oh, Seung Jin Kim, Kang Won Rhee, Kyung Mo Kim, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul 138-736, South Korea.Seak Hee Oh, Seung Jin Kim, Kang Won Rhee, Kyung Mo Kim, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul 138-736, South Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25759541

Citation

Oh, Seak Hee, et al. "Endoscopic Cyanoacrylate Injection for the Treatment of Gastric Varices in Children." World Journal of Gastroenterology, vol. 21, no. 9, 2015, pp. 2719-24.
Oh SH, Kim SJ, Rhee KW, et al. Endoscopic cyanoacrylate injection for the treatment of gastric varices in children. World J Gastroenterol. 2015;21(9):2719-24.
Oh, S. H., Kim, S. J., Rhee, K. W., & Kim, K. M. (2015). Endoscopic cyanoacrylate injection for the treatment of gastric varices in children. World Journal of Gastroenterology, 21(9), 2719-24. https://doi.org/10.3748/wjg.v21.i9.2719
Oh SH, et al. Endoscopic Cyanoacrylate Injection for the Treatment of Gastric Varices in Children. World J Gastroenterol. 2015 Mar 7;21(9):2719-24. PubMed PMID: 25759541.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic cyanoacrylate injection for the treatment of gastric varices in children. AU - Oh,Seak Hee, AU - Kim,Seung Jin, AU - Rhee,Kang Won, AU - Kim,Kyung Mo, PY - 2014/09/23/received PY - 2014/10/28/revised PY - 2014/12/05/accepted PY - 2015/3/12/entrez PY - 2015/3/12/pubmed PY - 2015/9/29/medline KW - Children KW - Complication KW - Cyanoacrylate KW - Endoscopic variceal obliteration KW - Gastric varix SP - 2719 EP - 24 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 21 IS - 9 N2 - AIM: To evaluate the efficacy and safety of N-butyl-2-cyanoacrylate in treating acute bleeding of gastric varices in children. METHODS: The retrospective study included 21 children with 47 episodes of active gastric variceal bleeding who were treated by endoscopic injection of N-butyl-2-cyanoacrylate at Asan Medical Center Children's Hospital between August 2004 and December 2011. To reduce the risk of embolism, each injection consisted of 0.1-0.5 mL of 0.5 mL N-butyl-2-cyanoacrylate diluted with 0.5 or 0.8 mL Lipiodol. The primary outcome was incidence of hemostasis after variceal obliteration and the secondary outcome was complication of the procedure. RESULTS: The 21 patients experienced 47 episodes of active gastric variceal bleeding, including rebleeding, for which they received a total of 52 cyanoacrylate injections. Following 42 bleeding episodes, hemostasis was achieved after one injection and following five bleeding episodes it was achieved after two injections. The mean volume of each single aliquot of cyanoacrylate injected was 0.3 ± 0.1 mL (range: 0.1-0.5 mL). Injection achieved hemostasis in 45 of 47 (95.7%) episodes of acute gastric variceal bleeding. Eleven patients (52.4%) developed rebleeding events, with the mean duration of hemostasis being 11.1 ± 11.6 mo (range: 1.0-39.2 mo). No treatment-related complications such as distal embolism were noted with the exception of abdominal pain in one patient (4.8%). Among four mortalities, one patient died of variceal rebleeding. CONCLUSION: Endoscopic variceal obliteration using a small volume of aliquots with repeated cyanoacrylate injection was an effective and safe option for the treatment of gastric varices in children. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/25759541/Endoscopic_cyanoacrylate_injection_for_the_treatment_of_gastric_varices_in_children_ L2 - https://www.wjgnet.com/1007-9327/full/v21/i9/2719.htm DB - PRIME DP - Unbound Medicine ER -