Endoscopic glue injection therapy with N-butyl-2-cyanoacrylate for bleeding from isolated large rectal varices

A 64-year-old woman with history of hepatitis C cirrhosis (Child-Pugh class C) was admitted to our institution with hematochezia. Her esophagogastric varices had been treated at our hospital 6 and 3 years previously by balloon-occluded retrograde transvenous obliteration (B-RTO) and endoscopic injection sclerotherapy (EIS), respectively, and she was being treated for refractory ascites with concentrated ascites reinfusion therapy (CART). She was found to be anemic (hemoglobin 6.0 g/dL) and renal dysfunction was also noted, with a blood urea nitrogen level of 117 mg/dL and creatinine level of 2.87 mg/dL. Plain abdominal computed tomography (CT) revealed liver cirrhosis with massive ascites ([Fig. 1]).