Author/Authors :
Tseng, Yujen Department of Gastroenterology - Zhongshan Hospital - Fudan University, China , Ma, lili Department of Endoscopy Center - Zhongshan Hospital - Fudan University, Shanghai, China , Luo, Tiancheng Department of Gastroenterology - Zhongshan Hospital - Fudan University, China , Zeng, Xiaoqing Department of Gastroenterology - Zhongshan Hospital - Fudan University, China , Wei, Yichao Department of Gastroenterology - Zhongshan Hospital - Fudan University, China , Li, Ling Department of Geriatrics - Zhongshan Hospital - Fudan University, Shanghai, China , Xu, Pengju Department of Radiology - Zhongshan Hospital - Fudan University, Shanghai, China , Chen, Shiyao Department of Gastroenterology - Endoscopy Center and Evidence-Based Medicine Center - Zhongshan Hospital - Fudan University, Shanghai, China
Abstract :
Background
Gastric varices (GV) are associated with high morbidity and mortality in patients with portal hypertension. Endoscopic cyanoacrylate injection is the first-line recommended therapy for GV obliteration. This study aims to explore the reason behind related adverse events and better prevent its occurrence.
Methods
A retrospective case series study was conducted from January 1, 2013, to December 31, 2016, to identify patients who experienced severe adverse events secondary to endoscopic cyanoacrylate injection. A literature review of similar cases was performed on two medical databases, Medline and Embase.
Results
A total of 652 patients underwent cyanoacrylate injection at our center within the study duration. Five cases of severe adverse events related to the use of tissue adhesives were identified. Detailed clinical presentation, patient treatment, and outcomes were reviewed and analyzed. Twenty-seven similar cases were identified based on the literature review providing further insight into the study.
Conclusion
Although rare in incidence, systemic embolism associated with cyanoacrylate injection is often fatal or debilitating. This report may raise awareness in treatment protocol, including the necessity of preoperative angiographic studies, to avoid similar adverse events in clinical practice.
