Distal biliary stricture as a complication of sclerosant injection for bleeding duodenal ulcer

A patient undergoing repeated endoscopic injection therapy for important bleeding from a duodenal ulcer developed intestinal perforation followed by extrahepatic obstructive jaundice resulting from benign biliary stricture. It is proposed that these complications were a consequence of the use of ethanolamine oleate as part of the injection regimen and caution against the use of this material is needed, particularly as current clinical trials suggest that sclerosants offer no advantage over injection therapy with dilute adrenaline alone.