A Case of Ruptured Duodenal Varix Treated Successfully by EIS Using N-butyl-2-cyanoacrylate

Abstract

The patient was a 37-year-old man who was diagnosed as having decompensated alcoholic liver cirrhosis in 201X −1 and had been visiting our department ever since. In 201X, he visited us with a several-days’ history of black stools. Examination revealed that he was in shock, and we suspected hemorrhagic shock due to bleeding from a ruptured gastrointestinal varix. High-dose fluid and vasopressor infusions were initiated, and emergency esophagogastroduodenoscopy （EGD）was performed. EGD confirmed a ruptured duodenal varix, and urgent endoscopic injection sclerotherapy（EIS）was performed using N-butyl-2-cyanoacrylate（NBCA）. The patient’s condition improved with the treatment, and he was discharged on day 10 of the illness. Emergency hemostasis by EIS may be useful in patients with Child-Pugh class C and low liver reserve, as in this case.