Bleeding duodenal varices successfully treated by endoscopic obliteration using N-butyl-2-cyanoacrylate (Histoacryl)

Abstract

A 53-year-old man with alcoholic liver disease was admitted to our hospital with symptoms of gastrointestinal hemorrhage. Emergency upper GI endoscopy was performed, detecting bleeding varices in the second part of the duodenum. Endoscopic obliteration using N-butyl-2-cyanoacrylate (Histoacryl, 0.5 ml) and lipiodol (0.3 ml) was performed. The varices were successfully obliterated, and no recurrent bleeding or complications were encountered. Treatment of bleeding duodenal varices has not been firmly established. Endoscopic procedures such as sclerotherapy or ligation, interventional radiology (IVR) , and surgical procedures have been reported. Endoscopic obliteration using Histoacryl was effective, and could become the first standard technique for bleeding duodenal varices.