A novel therapy for bleeding gastric varices

Two patients with the diagnosis of liver cirrhosis and portal hypertension related to hepatitis infection were admitted to Shanghai Ruijin hospital due to recurrent melena and hematemesis. Isolated gastric varices were observed in the gastric fundus during the retroflexion of gastroscope. The authors carried out endoscopic sclerotherapy using cyanoacrylate combined with aethoxysklerol for bleeding gastric varices, which disappeared dramatically within six months after two sclerotherapies for each patient. The compound effect of obliteration by α-cyanoacrylate alkyl and eradication by aethoxysklerol was satisfying. No complication and clinical signs of gastrointestinal re-bleeding were observed during six months of endoscopic follow-up. Meanwhile, follow-up of these two patients are still under way.

A report article to be published on 14 June 2008, in the World Journal of Gastroenterology addresses this case. The research team led by Yun-Lin Wu and his colleagues in the Ruijin Hospital Affiliated to Shanghai Jiaotong University carried out endoscopic sclerotherapy successfully using cyanoacrylate combined with aethoxysklerol for bleeding gastric varices, which disappeared dramatically within several months after two sclerotherapies for each patient.

CT portal angiography (CTPA) has come into wider spread of use in the assessment of variceal treatment and in further attempts to improve the results of endoscopic injection therapy. The authors detected the varices and made assessments of portosystemic collaterals through CTPA before sclerotherapy. After the injection of adhesives combined with sclerosants, CTPA revealed the vessels blocked by adhesive polymer, the obliteration and elimination of gastric varices, which were believed as a convincing sign of effective treatment.

Although the optimal treatment for gastric fundal variceal bleeding still remains controversial, the novel sclerotherapy using alpha -cyanoacrylate alkyl combined with aethoxysklerol coule be an alternative and feasible method for obliteration and eradication of gastric fundal varices.

Reference: Shi B, Wu W, Zhu H, Wu YL. Successful endoscopic sclerotherapy using cyanoacrylate combined with aethoxysklerol for bleeding gastric varices. World J Gastroenterol 2008;14(22): 3598-3601
http://www.wjgnet.com/1007-9327/14/3598.asp

Correspondence to: Yun-Lin Wu, Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, 197 Rui Jin Er Road, Shanghai 200025, China. wuyunlin1951@163.com
Telephone: +86-21-64370045 Fax: +86-21-64150773

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

The WJG Press mainly publishes World Journal of Gastroenterology.