Recurrent Bacteremia after Cyanoacrylate Sclerotherapy of Ectopic Duodenal Varices

• Autor(a) principal: Martins Mendes, Teresa
• Data de Publicação: 2023
• Outros Autores: Fonseca, Teresa, Pereira Anjos, Diana
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19444
• topic: Bacteremia/etiology; Enbucrilate/adverse effects; Esophageal and Gastric Varices/therapy; Gastrointestinal Hemorrhage; Sclerotherapy/ adverse effects; Bacteriemia/etiologia; Enbucrilato/efeitos adversos; Escleroterapia/efeitos adversos; Hemorragia Gastrointestinal; Varizes Esofágicas e Gástricas/tratamento

Sclerotherapy with N-butyl-2-cyanoacrylate is the first-line endoscopic approach for gastric and ectopic variceal bleeding, but it can be associated with local or systemic complications. Episodes of transient bacteremia after the procedure are frequent, but documented cases of recurrent bacteremia are rare. The authors report a 47-year-old female patient with liver cirrhosis who underwent duodenal sclerotherapy with cyanoacrylate after upper gastrointestinal bleeding. Subsequently, she developed five episodes of bacteremia with unknown origin. A definitive diagnosis of recurrent bacteremia due to cyanoacrylate was only possible after an exhaustive study to exclude other infectious foci. This case highlights a rare complication in an unusual topography (ectopic varices) and with a high number of episodes of bacteremia. A multidisciplinary management was paramount due to the patient’s high surgical and anesthetic risk, comorbidities, and surgical aggressiveness.