Successful endoscopic injection sclerotherapy with N-butyl-2-cyanoacrylate following the recurrence of bleeding soon after endoscopic ligation for ruptured duodenal varices.

Bleeding from duodenal varices in a 63-yr-old man with alcoholic cirrhosis of the liver was found at endoscopy, and ligation surgery was carried out. Ten months after the operation, bleeding from the duodenal varices occurred and was treated by endoscopic ligation. However, after performing this procedure, bleeding again occurred 1 week later. Hemostasis was finally achieved by endoscopic injection sclerotherapy with N-butyl-2-cyanoacrylate. For the 22 months since the injection, the patient has been free from further bleeding. These results suggest that endoscopic injection sclerotherapy with N-butyl-2-cyanoacrylate was effective in bringing about immediate cessation of the bleeding in duodenal varices and that long-term hemostasis can be expected.