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Volume 7, Issue 7 (Suppl) J Gastrointest Dig Syst
ISSN: 2161-069X JGDS, an open access journal Gastroenterologists 2017
December 14-15, 2017
December 14-15, 2017 Dubai, UAE
11th World
Gastroenterologists Summit
Effective hemostasis by spraying cyanoacrylate glue on difficult-to-control bleeding duodenal ulcer
Omar Naji Alnabihi1, Faisal M Sanai2, Faisal Batwa2 and Waleed Alshumrani2
1King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
2King Abdulaziz Medical City, Saudi Arabia
Upper gastrointestinal bleeding can be managed with a number of different endoscopic techniques. However, a small
number of patients have persistent bleeding requiring radiological or surgical intervention. Herein, we present a case
of massive duodenal ulcer bleeding that was managed by spraying cyanoacrylate glue on the duodenal ulcer after failure
of multiple modalities. A 44-year old female with multiple comorbidities including metastatic breast cancer presented with
melena. She was not using any anti-steroidal or anticoagulant medications. At admission, the heart rate was 132 beats per min,
supine blood pressure was 81/52 mmHg and FiO2 was 99%. An esophagogastroduodenoscopy (EGD) revealed an actively
bleeding duodenal ulcer, managed with injection of 10 ml of epinephrine (1:10,000) and by applying three endoclips and she
was maintained on proton pump inhibitor infusion. However, the bleeding recurred within 24 hours, with hemodynamic
instability, bright red blood in the naso-gastric tube and reduction in the Hb. A repeat EGD revealed active bleeding from
the ulcer. Argon plasma coagulation was applied repeatedly on the ulcer area that failed to control the profuse bleeding.
Subsequently, cyanoacrylate (Histoacryl®) was sprayed on to the ulcer surface that achieved immediate hemostasis. No further
bleeding occurred and the patient was discharged from the hospital after 7 days. This case demonstrates the potential efficacy of
cyanoacrylate glue spray on the ulcer surface for hemostasis in patients with difficult-to-control bleeding failing conventional
endoscopic therapies. Prospective studies with a larger number of patients are required to evaluate the role of the cyanoacrylate
spray technique for ulcer bleeding.
Biography
Omar Naji Alnabihi is currently a Medical Intern at King Abdulaziz Medical City in Saudi Arabia. He has completed his graduation from the College of Medicine from
King Saudi bin Abdulaziz University for Health Sciences in Saudi Arabia.
Omar Naji Alnabihi et al., J Gastrointest Dig Syst 2017, 7:7 (Suppl)
DOI: 10.4172/2161-069X-C1-062