PMC5228710_01
(Patient 1) Initial esophagogastroduodenoscopy (EGD) showed a polypoid jejunal varix with a whitish nipple sign just below the esophago-jejunal anastomosis site (A). A total of 2 mL of cyanoacrylate and lipiodol 1 : 1 mixture was injected into the jejunal varix (B). After 3 weeks, previously seen jejunal varices nearly disappeared (C) and a large amount of glue extrusion is observed (D).
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F1
Follow-up EGD after 3 weeks showed near resolution of the jejunal varix and a large amount of extruded glue casts (Fig. 1).
PMC5228710_02
PMC5228710_03
(Patient 3) EGD of the duodenum showed varices with erosion in the second to third portion of the duodenum is seen (A). A total of 2 mL of cyanoacrylate and lipiodol 1 : 1 mixture was injected into the duodenal varices (B). Previously seen duodenal varices nearly disappeared (C).
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F2
EGD showed duodenal varix with erosion, which was considered SRH. EVO was done with 2 mL of the cyanoacrylate and Lipiodol mixture in the second to third portion of the duodenum (Fig. 2).
PMC5228710_04
(Patient 4) EGD performed at first admission showed irregular venous engorgement with suspicious hematocystic spot in the 2nd portion of duodenum (A) and 4 hemoclips were applied (B). Three months later, remained duodenal varices were seen (C). Seven months later, EGD performed due to rebleeding demonstrated bluish nodular venous engorgements with bloody oozing in the 2nd portion of duodenum (D) and treated with EVL using 3 bands (E, F). EGD performed after 5 days of EVL showed ulcer bleeding with exposed vessel at previous EVL sites (G) and 3 hemoclips were applied (H).
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F3
Hemostasis was accomplished after application of 3 hemoclips (Fig. 3).
PMC5228710_05