Result of endoscopic treatment of gastric varices hemorrhagic by biological glue

F.Belabbes*, K .Benjouad , S . Oubaha, Z.Samlani, K.Krati
Page No. 61-66

Gastrointestinal hemorrhage (HD) by rupture of varicose veins is the most complicit complication
of death during cirrhosis. It is most often linked to a rupture of gastroesophageal varices.
Endoscopic obturation by biological glue of the various gastric (VG) is the treatment of choice. Our
aim is to evaluate the efficacy and safety of this therapeutic modality Material and methods We
conducted a retrospective study of patients who had gastrointestinal bleeding secondary to rupture
of gastric varices and treated with biological glue between January 2016 and April 2018 within our
department. Results We collected 55 cirhosis patients; The average age was 57.3 years [30-78] with
30 men and 25 women. Gastrointestinal haemorrhage was externalized as haematemesis in 31
cases, in the form of melena in 19 cases and in the form of haematemesis and melena in 5 cases. A
medical treatment based on Sandostatin * has been used in all patients .The mean hemoglobin level
was 5.8 g / dl. All patients were transfused on average with 2 red blood cells All patients had recent
bleeding stigmas at endoscopy. Gastric varices were distributed between stage I in 82.66% and
stage II in 17.34%.Concurrent oesophageal varices were noted in almost all patients. N-Butyl-2-
cyanoacrylate (Histoacryl) was the product used in all cases. The number of sessions ranged from 1
to 3 with an average of 1.59 sessions per patient. The mean follow-up of the patients was 24
months. There are also 4 PDV patients before the eradication and a failure by early haemorrhagic
recurrence by VG rupture). There is a mortality rate of 3.6% with two cases of death one by early
bleeding recurrence and the other by septic shock Conclusions Intravascular endoscopic
cyanoacrylate injection is a safe and effective therapeutic option for the treatment of acute gastric
varices bleeding.
Keywords : gastrointestinal bleeding, gastric varices, portal hypertension, biological glue, endoscopy