Successful endoscopic obturation of gastric varices with butyl cyanoacrylate

Authors

  • Dr. Marie-Jose Ramond,

    Corresponding author
    1. Service d'Hépatologie, Unité de Recherches de Physiopathologie Hépatique (INSERM), and Service d'Anatomie et de Cytologie Pathologiques, Hǒpital Beaujon, Clichy, France
    • Service d'Hépatologie, Hǒpital Beaujon, 92118 Clichy, France
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  • Dominique Valla,

    1. Service d'Hépatologie, Unité de Recherches de Physiopathologie Hépatique (INSERM), and Service d'Anatomie et de Cytologie Pathologiques, Hǒpital Beaujon, Clichy, France
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  • Jean-François Mosnier,

    1. Service d'Hépatologie, Unité de Recherches de Physiopathologie Hépatique (INSERM), and Service d'Anatomie et de Cytologie Pathologiques, Hǒpital Beaujon, Clichy, France
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  • Claude Degott,

    1. Service d'Hépatologie, Unité de Recherches de Physiopathologie Hépatique (INSERM), and Service d'Anatomie et de Cytologie Pathologiques, Hǒpital Beaujon, Clichy, France
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  • Jacques Bernuau,

    1. Service d'Hépatologie, Unité de Recherches de Physiopathologie Hépatique (INSERM), and Service d'Anatomie et de Cytologie Pathologiques, Hǒpital Beaujon, Clichy, France
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  • Bernard Rueff,

    1. Service d'Hépatologie, Unité de Recherches de Physiopathologie Hépatique (INSERM), and Service d'Anatomie et de Cytologie Pathologiques, Hǒpital Beaujon, Clichy, France
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  • Jean-Pierre Benhamou

    1. Service d'Hépatologie, Unité de Recherches de Physiopathologie Hépatique (INSERM), and Service d'Anatomie et de Cytologie Pathologiques, Hǒpital Beaujon, Clichy, France
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Abstract

In 27 patients who had bled from esophagogastric varices, large-sized and/or actively bleeding gastric varices were endoscopically obturated with the tissue adhesive butyl cyanoacrylate. Active bleeding was stopped in six patients. Rebleeding occurred in 10 patients; in four patients, rebleeding was due to ruptured gastric varices, occurred early and was successfully treated by reinjection of gastric varices; in one patient, rebleeding was attributed to ulceration on an injected gastric varix. Eight patients died: two of rebleeding (from esophageal varices or undetermined source), four of sepsis and/or liver failure and two at home of undetermined cause. No specific complication due to injection of gastric varices was observed. The results obtained in this series of patients with gastric varices obturated by injection of butyl cyanoacrylate are much more satisfactory than those obtained in previously published series of patients with gastric varices treated by injection of sclerosants.

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