Case Report
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World J Gastroenterol. Nov 14, 2014; 20(42): 15937-15940
Published online Nov 14, 2014. doi: 10.3748/wjg.v20.i42.15937
Endoscopic variceal ligation caused massive bleeding due to laceration of an esophageal varicose vein with tissue glue emboli
Xiu-Qing Wei, Hua-Ying Gu, Zhi-E Wu, Hui-Biao Miao, Pei-Qi Wang, Zhuo-Fu Wen, Bin Wu
Xiu-Qing Wei, Hua-Ying Gu, Zhi-E Wu, Hui-Biao Miao, Pei-Qi Wang, Zhuo-Fu Wen, Bin Wu, Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Author contributions: Wei XQ collected the data and wrote the paper; Wei XQ, Gu HY, Wu ZE, Miao HB, Wang PQ, Wen ZF and Wu B analyzed the data and diagnosed and treated the patient.
Supported by National Natural Science Foundation of China, No. 81272640 and No. 81470848; and Guangdong Science and Technology Program, No. 2010B031200008 and No. 2012B031800043
Correspondence to: Xiu-Qing Wei, MD, PhD, Associate Professor, Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou 510630, Guangdong Province, China. wei-xiuqing@163.com
Telephone: +86-20-85253095 Fax: +86-20-85253336
Received: June 18, 2014
Revised: August 29, 2014
Accepted: September 29, 2014
Published online: November 14, 2014
Processing time: 151 Days and 15.8 Hours
Abstract

Endoscopic variceal obturation of gastric varices with tissue glue is considered the first choice for management of gastric varices, and is usually safe and effective. However, there is still a low incidence of complications and some are even fatal. Here, we present a case in which endoscopic variceal ligation caused laceration of the esophageal varicose vein with tissue glue emboli and massive bleeding after 3 mo. Cessation of bleeding was achieved via variceal sclerotherapy using a cap-fitted gastroscope. Methods of recognizing an esophageal varicose vein with tissue glue plug are discussed.

Keywords: Gastroesophageal varices; Variceal bleeding; Laceration; Varices ligation; Tissue glue injection

Core tip: Complications can occur during and after treatment of gastric varices via endoscopic variceal obturation with tissue glue. Laceration of the esophageal varicose vein with tissue glue emboli and massive bleeding caused by endoscopic variceal ligation are reported here. Cap-fitted gastroscopy may be helpful in sclerotherapy for cardiac varices by providing better endoscopic vision.