Atlas of Gastroenterological Endoscopy
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Hemorrhage from fundal varices
Bleeding fundal varices Condition after evacuating blood First Histoacryl injection
Tortuous fundal varices showing an acute hemorrhage. The visible gastric mucosa carries characteristic cherry red spots allowing the diagnosis of hepatic gastropathy. Rinsing off the blood renders possible the indentification of the exact site of hemorrhage. At the left side an injection needle is visible. After the first dose of HistoacrylŽ injected to the varice the activity of bleeding is already reduced.
Sclerotherapy with 3 * 0,5 ml Histoacryl After 3 injections of 0,5 ml of HistoacrylŽ complete hemostasis is achieved. Large injections at a time are not advisable for the danger of embolisation (slow polymerisation). The former origin of hemorrhage is still discernable. Paravasal applications of tissue adhesives bear the acute danger of necrosis. Injection of the adhesive just next to the bleeding allows observation of adhesive material oozing out of the bleeding site. This in return proves correct intravasal injection.
  • Blutungsquelle = source of bleeding
  • Injektionsort = location of injection