Pulmonary Glue Embolism An unusual complication following endoscopic sclerotherapy for gastric varices
Journal Title: Sultan Qaboos University Medical Journal - Year 2018, Vol 18, Issue 2
Abstract
A pulmonary glue embolism is an unusual but potentially life-threatening complication following the treatment of variceal bleeding, especially in patients with large varices requiring large volumes of sclerosant. Other contributory factors include the rate of injection and ratio of the constituent components of the sclerosant (i.e. n-butylcyanoacrylate and lipiodol). Tis condition may be associated with a delayed onset of respiratory compromise. Terefore, a high degree of clinical suspicion is essential in patients with unexplained cardiorespiratory decline during or following endoscopic sclerotherapy. We report a 65-year-old man who was admitted to the Hull Royal Infrmary, Hull, UK, in 2017 with haematemesis and melaena. He subsequently developed acute respiratory distress syndrome secondary to a glue embolism following emergency sclerotherapy for bleeding gastric varices. Te aetiology of the embolism was likely a combination of the large size of the gastric varices and the large volume of cyanoacrylate needed. After an endoscopy, the patient underwent transjugular intrahepatic portosystemic shunting twice to control the bleeding, after which he recovered satisfactorily.
Authors and Affiliations
Philips G. Michael, Georgios Antoniades, Anca Staicu, Shahid Seedat
Keywords
Related Articles
- EP ID EP29175
- DOI -
- Views 407
- Downloads 21
ABC of the First Year
Embolization of Ruptured Hepatic Hydatid Cyst to Pulmonary Artery in an Elderly Patient Multidetector computed tomography fndings
Pulmonary embolism due to hydatid disease is an unusual condition resulting from the rupture of a hydatic heart cyst or the opening of liver hydatidosis into the venous circulation. A 78-year old male patient complaini...
Assessment Methods in Undergraduate Medical Education
Various assessment methods are available to assess clinical competence according to the model proposed by Miller. Te choice of assessment method will depend on the purpose of its use: whether it is for summative purpos...
Transfusion in Haemoglobinopathies Review and recommendations for local blood banks and transfusion services in Oman
Sickle cell disease and homozygous β-thalassaemia are common haemoglobinopathies in Oman, with many implications for local healthcare services. The transfusions of such patients take place in many hospitals throughout...
Bilateral Asymmetrical Traumatic Sternoclavicular Joint Dislocations
Unilateral and bilateral sternoclavicular joint (SCJ) dislocations are rare injuries. Te difculty in assessing this condition often leads to delay in diagnosis and treatment. We report a rare case of bilateral asymmetr...