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UNUSUAL FOREIGN BODY: ESOPHAGEAL IMPACTION AFTER CYANOACRYLATE INJECTION FOR GASTRIC VARICES
Author(s) -
Cinar Kubilay,
Onder Fatih Oguz,
Nazligul Yasar,
Dokmeci Abdulkadir,
Ormeci Necati
Publication year - 2006
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.0915-5635.2006.00631.x
Subject(s) - medicine , cyanoacrylate , dysphagia , esophagus , endoscopy , retching , surgery , gastric varices , foreign body , esophageal varices , vomiting , endoscope , varices , portal hypertension , cirrhosis , gastroenterology , chemistry , adhesive , organic chemistry , layer (electronics)
Cyanoacrylate injection has been found in large series to be a remarkably safe and efficient treatment of gastric variceal bleeding. Dysphagia is a common local side‐effect of endoscopic intravariceal histoacryl injection. A 49‐year‐old woman with diagnosis of cirrhosis and portal hypertension related to hepatitis B virus infection was admitted to the Ibni Sina hospital due to dysphagia that started after injection of N ‐butyl‐2‐cyanoacrylate (histoacryl) for gastric varices. She had undergone endoscopic gastric intravariceal histoacryl injection 2 years previously and again 1 month before the admission. There were no complications related to injection of the histoacryl or the endoscopy procedure itself. Dysphagia started immediately after the second endoscopy and was refractory to prokinetic and analgesic medication. She did not have any other complaint of medical significance. A diagnostic endoscopy revealed a heterogeneous foreign body stuck in the distal esophagus. Dysphagia resolved after endoscopic removal of the foreign body by endoscopic biopsy forceps. The heterogeneous material, which was mixed with food particles and tissue debris, was analyzed via infrared spectrophotometer and was found to be cyanoacrylate glue. In the present case, extrusion of the glue occurred earlier then expected and retching or vomiting might have dislodged the extruded glue from the stomach to the esophagus. If prolonged and intractable dysphagia starts after the endoscopy procedure, impaction of glue to the esophagus should be considered.