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Case Report
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| Endoscopic injection of Histoacryl® in the treatment of recurrent hematuria secondary to bladder varices |
| Sivaprakasam Sivalingam1, Rishya Manikam2, Muhilan Parameswaran1, Azad Hassan Razack1, Nasir Mohamad3 |
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1Department of Surgery, Division of Urology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
2Department of Emergency Medicine, Faculty of Medicine, University Malaya, Malaysia. 3Department of Emergency Medicine and Department of Surgery, School of Medical Sciences, University Sains Malaysia, Health Campus, Kelantan, Malaysia. |
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10.5348/ijcri-2011-10-58-CR-2
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Address correspondence to: Dr. Nasir Mohamad Department of Emergency Medicine School of Medical Sciences Universiti Sains Malaysia 16150 Kubang Kerian Kelantan Malaysia Phone: 60199388078 Fax: 6097489951 Email: drnasirmohamadkb@yahoo.com |
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| How to cite this article: |
| Sivalingam S, Manikam R, Parameswaran M, Razack AH, Mohamad N. Endoscopic injection of histoacryl® in the treatment of recurrent hematuria secondary to bladder varices. International Journal of Case Reports and Images 2011;2(10):6-9. |
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Abstract
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Introduction:
Macroscopic haematuria involving bladder varices is a rare presentation to Emergency Department. Its presentation warrants immediate diagnosis and management to prevent severe anaemia and hypovolaemia. Injection therapy may be an option that can be offered as an alternative procedure to treat gross hematuria. It is considered less invasive when compared to an open surgery especially in high morbidity patients. We described an alternative treatment modality in the treatment of bleeding bladder varices using endoscopic injection of Histoacryl® (N-butyl-2-Cyanoacrylate).
Case Report: This case report describes a female patient who presented to the ED with bleeding bladder varices secondary to portal hypertension in an ileal augmented bladder. The report discusses an alternative treatment modality to treat bleeding bladder varices using endoscopic injection of Histoacryl® (N-butyl-2-Cyanoacrylate). Discussion: Macroscopic haematuria is a common presentation to the Emergency Department (ED). Nevertheless, haematuria secondary to urinary bladder varices is an unusual presentation. Bladder varices secondary to portal hypertension is rare since the bladder wall is not the usual collateral route for venous splanchnic blood flow. Bladder varices may occur in patients with portal hypertension in circumstances where the normal splanchnic collaterals fail to develop due to prior obliteration from treatments such as surgery, sclerotherapy or ligation. The second probability is when the anatomy of the venous drainage of the bladder is altered from surgery such as bladder augmentation with a bowel segment. Conclusion: Histoacryl® injection therapy can be regarded as an effective alternative in the management of patient with bleeding bladder varices. | |
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Key Words:
Haematuria, Bladder varices, Histoacryl
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Author Contributions:
Sivaprakasam Sivalingam - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Rishya Manikam - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Muhilan Parameswaran - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Azad Hassan Razack - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Nasir Mohamad - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission:
The corresponding author is the guarantor of submission. |
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Source of support:
None |
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Conflict of interest:
Authors declare no conflict of interest. |
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Copyright:
© Sivaprakasam Sivalingam et al. 2011; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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