Keywords:
Gastrointestinal tract
Authors:
A. J. Swift, W. H. K. CHIU, A. Razack; Hull/UK
DOI:
10.1594/ecr2010/C-3312
Results
Following fibrin-glue injection, 3 of 4 four cases showed complete occlusion of track, with no contrast passing through the leak on subsequent contrast study. One patient who had a > 2cm neck to the leak required two treatments using the same method before the leak was successfully treated.
All four patients were re-commenced on oral feeds and made a good recovery and the stents were removed between 6 and 8 weeks.
From our work several technical issues have arisen. The double lumen catheter which is used to keep the components of Tisseel separate to avoid setting of the fibrin-glue within the cather, does not allow for passage of a guide wire. Hence we injected the sealant down the 75 cm 5F KMP catheter (Cook, Bloomington, Ind). 10ml of solution was successfully injected before the sealant set within the catheter.
The problem of radiographic visualisation of injected fibrin glue has been addressed previously with barium impregnated fibrin sealant to close fistulas in interventional radiologic procedures described in 1993 [4]. However, this has not become part of routine practice because of the possible risk of infection [5]. Non-visualisation of fibrin glue on fluoroscopy is a limitation of the technique.