Percutaneous transhepatic obliteration with N-butyl-2-cyanoacrylate in a patient with a superior mesenteric vein intraluminal distal small bowel variceal bleed

Abstract

Gastrointestinal (GI) bleeding is a serious complication with a high mortality rate (45%-55%) that can result from a variety of conditions, including portal hypertension, diverticulosis, or splenic vein thrombosis. There are a variety of established treatment strategies for GI bleeds, and there are different indications and contraindications for each. In this case, colonoscopy did not identify any active source of bleeding. Furthermore, because this GI hemorrhage did not involve any shunts, balloon-occluded retrograde transvenous obliteration was not performed. Additionally, a transjugular intrahepatic portosystemic shunt was ruled out due to the poor primary shunt patency rate. Here, we report the treatment of a GI bleed with N-butyl-2-cyanoacrylate (n-BCA) liquid embolization with no complications. This case demonstrates the potential of using n-BCA to treat small bowel varices.

Keywords

• embolization, therapeutic
• enbucrilate
• gastrointestinal hemorrhage
• mesenteric veins
• tissue adhesives