Clinical characteristics and endoscopic treatment with cyanoacrylate injection in patients with duodenal varices

Objective. To summarize the clinical characteristics and evaluate the effectiveness of cyanoacrylate injection in patients with duodenal varices (DV). Material and methods. Between June 2003 and June 2008 all patients with DV (n = 14) were analyzed retrospectively. Their clinical characteristics, endoscopic diagnoses and values of endoscopic cyanoacrylate injection were summarized. Results. Fourteen of 396 patients receiving endoscopic treatment for upper gastroesophageal varices were diagnosed with DV. Four of these patients underwent endoscopic cyanoacrylate injection, with satisfactory results. No episodes of rebleeding occurred after 7-30 months' follow-up. Viral hepatitis-associated cirrhosis is the most common cause of DV (8/14), and the second section of the duodenum is the most common location of DV (14/14). Conclusions. The second section of the duodenum should be routinely endoscopically examined to identify and evaluate DV in all patients with gastroesophageal varices, and endoscopic cyanoacrylate injection appears to be a simple and effective hemostatic measure for DV bleeding.