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Endoscopic Treatment of Gastroduodenals Varices by Chemical Glue Mixed with Glucose Serum

Author: Asmae Sejai Lamine, S. Adadi, Ihsane Mellouki, Mounia El Yousfi, Nourdin Aqodad, Mohamed El Abkari, Adil Ibrahimi, Dafr-Allah Benajah

Category: JMSR Gastroenterology


Introduction: The incidence of digestive bleedings secondary to the rupture of gastroduodenal varices ranges from 3 to 30%. They represent approximately 10 % of all the high bleedings associated with a portal hypertension. The purpose of this work is to estimate the therapeutic efficiency and the complications of the injection of chemical glue diluted with glucose solution5% as a technique for endoscopic hemostasis.

Patients and methods: It's a retrospective study concerning 15 patients between 2012 and 2014. All the patients were admitted for upper gastrointestinal bleeding. They all underwent oesogastro- duodenal endoscopy which objectified bleeding caused by rupture of gastroduodenal varices. Patient's consent was mandatory. N-butyl-2-cyanoacrylate was associated with methacryl oxysulfolane (Glubran 2) prepared with glucose serum 5%. The endoscopic treatment was realized under sedation and consisted in the injection of chemical glue intravariceally.

Results: The injection of glue in the gastric varicose veins was realized in 13 patients (86.7%) and in duodenal ectopic varices in two patients (13. 3 %). The injection was realized in one or two sites of the ruptured varicose vein. The mean age of the patients was 51 years old [23 - 76]. Female gender was prominent (n= 11; 76 %).The initial hemostasis was obtained in 100 % of cases. We noted a second recurrence in two patients, no immediate or delayed complication were reported.

Conclusion: The hemostatic endoscopic treatment of the upper bleedings, caused by the rupture of gastroduodenal varicose veins, using chemical glue diluted in glucose serum 5% seems effective and less expensive compared to the dilution in Lipiodol. Our results are preliminary and must be confirmed in the future by a more important sample.

Keywords: Chemical glue, Gastroduodenals varices, Glucose serum, Mixture


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