Korean Journal of Gastrointestinal Endoscopy 1999;19(1): 59-66.
위정맥류출혈에서 Histoacryl 주입으로유발된 폐색전증 1 예 (A Case of Pulmonary Embolism Induced by Complication of Histoacryl Injection Therapy in Gastric Varix Bleeding )
송치원, 박태욱, 김탁용, 이동수, 김상우, 변병훈, 최종영, 양영상, 정인식, 박두호, 김부성 (Chi Won Song, Tae Wook Park, Tak Yong Kim, Dong Soo Lee, Sang Woo Kim, Byung Hun Byun, Jong Young Choi, Young Sang Yang, In Sik Chung, Doo Ho Park and Boo Sung Kim)
Abstract
N-Butyl-2-cyanoacrylate (Histoacryl) has been used successfully to control bleeding from esophagogastric varices since the first report in 1986 by Soehendra. Complications of Histoacryl injection include local sloughing with ulcer formation, rebleeding, sepsis, mediastinitis, esophageal strictures and fever. Systemic embolization, including pulmonary and cerebral embolization, has been reported. We describe here the presentation of an un-usual complication of Histoacryl injection. A 42-year-old woman presented with an attack of massive hematemesis. Endoscopy revealed bleeding evidence of gastric varices. Sclero-therapy was carried out using Histoacryl mixed with Lipiodol (ratio 1 ：1), with complete solidification of the varix. Next morning she complained of dyspnea and tachycardia. The chest x-ray showed multiple metallic densities, consistent with cyanoacrylate mixed with lipoidol, located at central portion. She was diagnosed as having pulmonary embolism by convential precontrast chest CT. She was treated conservatively using oxygen and analge-sics. She recovered soon and was discharged without significant problems. (Korean J Gastrointest Endosc 19: 59 ∼64, 1999)
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