Endoscopic hemostasis using fibrin adhesive to treat hemorrhage in the upper digestive system.
OBJECTIVE
There are several methods of achieving endoscopic hemostasis of hemorrhage in the upper digestive system. We compared the therapeutic results and advantages of using a local injection of fibrin adhesive for endoscopic hemostasis, which we have found more effective than other hemostatic methods.


METHODS
Between October 2000 and April 2002, 16 patients with hemorrhage in the upper digestive system underwent endoscopic hemostasis using fibrin adhesive. The hemorrhage was caused by a hemorrhagic tendency from liver disease, anticoagulant therapy, or failed hemostasis with clipping or local ethanol injection. The fibrin adhesive was injected through a standard 21-gauge endoscopic needle using the so-called sandwich method.


RESULTS
Hemostasis was successfully achieved by a single local injection of fibrin adhesive, in all except one patient who had been on anticoagulant therapy for a long time and needed an additional local injection of fibrin adhesive.


CONCLUSIONS
Fibrin adhesive does not cause any tissue injury, and a sufficient amount can be injected endoscopically even in patients with liver dysfunction and those on anticoagulant therapy. Thus, we think that endoscopic hemostasis with fibrin adhesive is safe and effective.
Suga
Hiroyasu
H
Department of Emergency Medicine, Tokyo Women's Medical University, Daini Hospital, Tokyo, Japan.
Nakagawa
Takao
T
Soga
Yukihiro
Y
Takahashi
Haruki
H
Abe
Masaru
M
Deguchi
Yoshizumi
Y
Tunoyama
Taiichiro
T
Suzuki
Tadashi
T
Imamura
Yoshiaki
Y
Fukuda
Masaru
M
D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000628:therapy; D005773:Gastroscopy / Q000379:methods; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D011446:Prospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive