Abstract | BACKGROUND: Although endoscopic therapy is highly effective for control of GI bleeding, a small proportion of patients experience persistent bleeding and may require radiologic or surgical intervention. Experience with cyanoacrylate spray for treatment of difficult-to-control GI bleeding is limited. OBJECTIVE: To evaluate the efficacy and safety of an endoscopic cyanoacrylate spray technique for treatment of difficult-to-control GI bleeding. DESIGN: Case series. SETTING: Two tertiary-care centers. PATIENTS: INTERVENTION: MAIN OUTCOME MEASUREMENTS: Hemostasis, rebleeding, adverse events, and technical failure associated with cyanoacrylate spray. RESULTS: Five patients were treated with cyanoacrylate spray during endoscopy for persistent bleeding ( duodenal ulcer in 3, gastric vascular ectasia in 1, rectal postpolypectomy bleeding in 1) after failed conventional therapies. Immediate hemostasis and technical success were achieved in all patients. At a median follow-up of 42 days (range 38-120 days), 2 patients developed recurrent bleeding. One patient experienced rebleeding 2 days after the procedure, subsequently requiring radiographic intervention and surgery. Another patient had recurrent bleeding from a different bleeding source 18 days after the procedure. No adverse events attributed to the cyanoacrylate spray were observed. LIMITATIONS: Small number of patients. CONCLUSION: In patients with difficult-to-control GI bleeding failing conventional endoscopic therapies, cyanoacrylate spray was effective in achieving immediate hemostasis. Prospective studies with a larger number of patients to evaluate the role of the cyanoacrylate spray technique during endoscopy for GI bleeding are needed.
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Authors | Sukhpreet S Walia, Aadesh Sachdeva, John J Kim, Donald J Portocarrero, Terence D Lewis, Yan S Zhao |
Journal | Gastrointestinal endoscopy
(Gastrointest Endosc)
Vol. 78
Issue 3
Pg. 536-9
(Sep 2013)
ISSN: 1097-6779 [Electronic] United States |
PMID | 23948199
(Publication Type: Journal Article)
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Copyright | Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Duodenal Ulcer
(complications)
- Enbucrilate
(administration & dosage, adverse effects)
- Female
- Gastric Antral Vascular Ectasia
(complications)
- Gastrointestinal Hemorrhage
(etiology, therapy)
- Hemostasis, Endoscopic
(methods)
- Humans
- Intestinal Polyps
(surgery)
- Male
- Middle Aged
- Peptic Ulcer Hemorrhage
(complications, therapy)
- Postoperative Hemorrhage
(etiology, therapy)
- Rectal Diseases
(surgery)
- Recurrence
- Retreatment
(methods)
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