polidocanol and Hemorrhage

To compare the efficacy and safety of the modified sandwich method with lauromacrogol in the treatment of gastric variceal bleeding (GVB) caused by liver cirrhosis with the traditional sandwich method no accompanied by lauromacrogol via a meta-analysis.. The Cochrane Library, Pubmed, the China National Knowledge Infrastructure (CNKI) database, the Chinese Wanfang database, and the Chongqing VIP database were searched to identify cohort studies comparing modified to traditional sandwich method in the treatment of GVB with liver cirrhosis. The relative risk for hemostasis rate, gastric varices (GV) remission rate, re-bleeding rate, the incidence of post-operative complications (pain, fever, ulcer or erosion, ectopic embolism), and all-cause mortality were calculated. The mean difference for average tissue adhesive dosage per case was calculated. Relevant data were analyzed with the Reviewer Manager 5.3.5.. Four cohort studies with a total of 587 patients were included in this meta-analysis. In the treatment of GVB with liver cirrhosis, compared with the traditional sandwich method, the modified sandwich method was associated with a higher GV remission rate (RR: 1.24, 95% CI: 1.09-1.42; P = .001) according to the pooled results. There were no statistically significant differences between the 2 methods in the rate of hemostasis, re-bleeding, pain, fever, ulcer or erosion, ectopic embolism, and all-cause mortality (P ≧ .05).. This meta-analysis indicated that the modified sandwich method with lauromacrogol is more effective than the traditional sandwich method without lauromacrogol. Due to the limited number of studies and samples, more RCT studies are needed to further validate the efficacy and safety of the modified sandwich method with lauromacrogol in the treatment of GVB with liver cirrhosis.

Topics: Esophageal and Gastric Varices; Hemorrhage; Humans; Liver Cirrhosis; Polidocanol; Sclerosing Solutions; Sclerotherapy; Tissue Adhesives

A physician was found guilty of negligence after blindness occurred subsequent to an injection of Aethoxysclerol into the nasal septum. A review of the literature on visual impairment after the injection of various substances in the nose and head is given. The incidence and pathogenesis of blindness after intranasal injections are discussed.

Topics: Blindness; Hemorrhage; Humans; Malpractice; Nasal Septum; Nose Diseases; Polidocanol; Polyethylene Glycols; Sclerosing Solutions

Endoscopic sclerotherapy is of proven benefit for patients after esophageal variceal bleeding, but is associated with substantial local and systemic complications. Since fibrin glue is a promising agent for endoscopic sclerotherapy of esophageal varices, we compared its safety and efficacy in patients after esophageal variceal bleeding.. In a randomized, controlled trial, 36 patients with an acute episode of variceal bleeding were endoscopically treated with either polidocanol (18 patients) or fibrin glue (18 patients) by intravariceal injections within 12 h of admission. Tissue compatibility, incidence of various complications, episodes of rebleeding and overall survival rates were investigated.. Rebleeding, especially from enrollment to day 28, was less common in the fibrin group (p=0.046), and all patients treated with fibrin glue survived for more than 28 days, whereas five patients treated with polidocanol died within this period. The incidence of sclerotherapy-induced ulcers was significantly lower in the fibrin group than in the polidocanol group (p=0.001), and major complications such as perforation or ulcer bleeding were observed only in the polidocanol group. There were no complications in any group due to activation of systemic coagulation, fibrinolysis or clinically relevant pulmonary embolization.. We conclude that fibrin glue is an efficient and safe agent for endoscopic sclerotherapy of bleeding esophageal varices, especially in the immediate posthemorrhagic period.

Topics: Aged; Esophageal and Gastric Varices; Esophagoscopy; Female; Fibrin Tissue Adhesive; Follow-Up Studies; Hemorrhage; Hemostasis, Endoscopic; Hemostatics; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Recurrence; Sclerosing Solutions; Sclerotherapy

Arteriovenous malformation (AVM) sometimes causes hemorrhage that can be fatal. We report a case of AVM of the tongue with bleeding that was treated by semi-emergent sclerotherapy with polidocanol. A 33-year-old woman presented with Schobinger stage III AVM of the tongue. Sclerotherapy with 3% polidocanol foam was performed under general anesthesia using curved intestinal forceps to clamp the root of the tongue for control of blood flow. Postoperatively, there was no further bleeding from the lesion. Three subsequent sclerotherapy sessions with polidocanol were performed, and there was a marked reduction in the size of the lesion. The lesion has remained well controlled in the year since the last sclerotherapy session.

Topics: Adult; Arteriovenous Malformations; Female; Hemorrhage; Humans; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Surgical Instruments; Tongue; Treatment Outcome

The bleeding from various veins can be intense and may be mistaken for arterial haemorrhage. Several fatal cases are reported due to delay of treatment and inappropriate first aid. We describe five cases of haemorrhage from varicose veins that were treated with foam sclerotherapy. Polidocanol foam was injected in the various veins using ultrasound guidance. There was no recurrence of haemorrhage in any patient during the 17.4 months follow-up period. Foam sclerotherapy can be performed easily in an out-patient clinic setting. This method is an ideal therapy for haemorrhage from varicose veins because it mitigates problematic varicose veins.

Topics: Adult; Aged; Female; Hemorrhage; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Varicose Veins

Topics: Adolescent; Adult; Aged; Epistaxis; Female; Hemorrhage; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Telangiectasia, Hereditary Hemorrhagic; Telangiectasis

Hepatic bleeding following abdominal trauma is a serious problem. The implementation of various materials and techniques have been attempted to prevent bleeding but a standard method is indefinite.. Hepatic resection model was performed on rats. The efficacy of hemostasis with Polidocanol and Tetradecyl Sulfate has been evaluated through the comparison of perioperative bleeding amount and preoperative and postoperative hematocrit levels in the 24th hour. Also, histopathologic changes on parenchyma have been compared at a microscopic level.. Preoperative and postoperative hematocrit differences were 5.50 +/- 0.59 in Polidocanol group and 10 +/- 1.30 in Tetradecyl Sulfate group (MW: 2, p < 0.001). Perioperative bleeding amounts were: 1.50 +/- 0.20 mL in the Polidocanol group, 3.50 +/- 0.15 mL in the Tetradecyl Sulfate group and 7.50 +/- 0.41 mL in the Control Group. Upon comparison of perioperative bleeding amounts: the Control Group values were very high in comparison to the Polidocanol group (p < 0.001) and the Tetradecyl Sulfate group values were higher than those of the Polidocanol group (p < 0.05).. Local sclerosing agents, especially Polidocanol, appear to be an effective alternative method in hemostasis of hepatic bleeding.

Topics: Animals; Female; Hemorrhage; Hemostasis; Liver Diseases; Polidocanol; Polyethylene Glycols; Rats; Rats, Wistar; Sclerosing Solutions; Sodium Tetradecyl Sulfate

Topics: Chronic Disease; Cystitis; Hematuria; Hemorrhage; Humans; Laser Coagulation; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy

To establish the utility of endoscopic sclerotherapy using 1% ethoxysclerol for the control of intractable hematuria following post-irradiation telangiectatic cystitis (PTC).. Our experience of treating 4 patients (one female and three male) with massive exsanguinating hematuria resulting from PTC, using a combined intralesional and perilesional injection of 1% ethoxysclerol, is presented. Observation on the distribution, grading of telangiectasis and pattern of bleeding are made.. A dramatic and lasting cessation of the hematuria in all the 4 patients was achieved during the follow-up period varying from 1 month to 4 years.. Endoscopic injection sclerotherapy is a simple, highly effective, less invasive new technique in the management of massive and intractable hematuria due to radiation-induced telangiectasia of the urinary bladder.

Topics: Adult; Cystitis; Female; Hematuria; Hemorrhage; Humans; Injections, Intralesional; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Radiotherapy; Sclerosing Solutions; Sclerotherapy

Endoscopic papillotomy as therapeutic procedure of first choice for common bile duct stones is related with a relatively low complications rate and exhibits a very low method-related mortality. Major complications are cholangitis, pancreatitis, retroduodenal perforation and hemorrhage. In rare cases minor bleedings after papillotomy may lead to coagulation with consecutive obstruction of the papilla. Jaundice without major clinical symptoms will occur. Diagnosis is established by repeated retrograde cholangiography; conservative management is satisfactory and efficient.

Topics: Aged; Aged, 80 and over; Ampulla of Vater; Cholangiopancreatography, Endoscopic Retrograde; Cholestasis, Extrahepatic; Female; Gallstones; Hemorrhage; Humans; Polidocanol; Polyethylene Glycols; Postoperative Complications; Thrombosis

Topics: Endoscopy; Esophageal and Gastric Varices; Heart Failure; Hemorrhage; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols

In spite of extensive experience based on animal experiments and human treatment, a unilateral, irreversible amaurosis occurred in one case of paravascular sclerotherapy of epistaxis with Aethoxysklerol. The strict submucosal application of Aethoxysklerol does not cause a mural thrombosis but leads to narrowing of the vessels (e.g., in the region of the Locus Kiesselbachii) due to gradual subepithelial sclerosis of the mesenchymal tissue. Temporary or permanent amaurosis has also been described in cases of injection of local anesthetics or glucocorticoid crystalline suspensions in the facial and neck region. From the pathophysiological point of view, allergic reactions, neuroreflex vascular spasm, or micro embolism of the central retinal artery have to be considered. The incident on which this paper is based led to a liability lawsuit. Judgement was given against the attending doctor because of severe bodily injury.

Topics: Adult; Blindness; Female; Hemorrhage; Humans; Malpractice; Nose Diseases; Polidocanol; Polyethylene Glycols; Sclerosing Solutions