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  • Title: [Fundal variceal bleeding treated with balloon occluded endoscopic inyection sclerotherapy. Report of two cases].
    Author: Costa DD, Montenegro C, Palavecino P, Lobos G, Cermenati T, Poniachik J.
    Journal: Rev Med Chil; 2017 Oct; 145(10):1336-1341. PubMed ID: 29488575.
    Abstract:
    Management of gastrointestinal bleeding caused by fundal varices is particularly difficult to manage. The options are: transjugular intrahepatic portosystemic shunt (TIPS), endoscopic injection of cyanoacrylate or balloon-occluded retrograde transvenous obliteration (BRTO). We report a 63 year-old male with a cirrhosis caused by hepatitis C and a 66 year-old female with a cirrhosis caused by a non-alcoholic steatohepatitis. Both patients had a gastrointestinal bleeding caused by fundal varices and were treated with sclerotherapy with cyanoacrylate assisted with BRTO. Flow was interrupted in the gastro-renal shunt by a femoral access in both patients. The male patient had a new bleeding two months later and died. In the female patient an endosonography performed nine months after the procedure showed absence of remaining varices.
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