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Canadian Journal of Gastroenterology
Volume 23, Issue 6, Pages 412-414
http://dx.doi.org/10.1155/2009/182082
Brief Communication

A Noninvasive Imaging Technique to Evaluate Therapeutic Efficacy after Injection of n-Butyl-2-cyanoacrylate Tissue Adhesive into Gastric Varices: A Case Report

Bret J Spier,1 Andrew J Taylor,2 Patrick R Pfau,1 Adnan Said,1 and Deepak V Gopal1

1Section of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
2Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA

Received 9 May 2008; Accepted 4 June 2008

Copyright © 2009 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A novel use of multidetector computed tomographic intravenous (MDCT IV) portography in the evaluation of gastric varices treated with tissue adhesive is described. A 55-year-old man presented with upper gastrointestinal hemorrhage as a result of bleeding gastric varices. The patient was stabilized and the gastric varices were treated with n-butyl-2-cyanoacrylate (two injections, total 7.5 mL). MDCT IV portography performed after injection revealed thrombosis of all but one of the submucosally based gastric varices. The endoscopist who performed repeat endoscopy three weeks later was then able to direct therapy at the remaining patent submucosally based gastric varix. This represents the first reported use of MDCT IV portography in the evaluation of treatment adequacy in a patient with gastric varices treated with n-butyl-2-cyanoacrylate.