title: Application of cyanoacrylate in difficult-to-arrest acute non-variceal gastrointestinal bleeding.
abstract: Gastrointestinal bleeding is a common medical emergency. Although endoscopic treatment is effective in controlling non-variceal upper gastrointestinal bleeding, in cases of persistent bleeding radiological or surgical interventions are required. Application of cyanoacrylate for treatment of difficult-to-arrest non-variceal upper gastrointestinal bleeding is poorly investigated. We describe patients in whom cyanoacrylate for acute non-variceal gastrointestinal bleeding was used to stop the bleeding after failure of conventional endoscopic treatment. Five patients were treated with cyanoacrylate application (injection and/or spraying) for persistent bleeding (duodenal ulcer in 3, gastric ulcer in 1 and gastric Dieulafoy's lesion in 1) despite conventional endoscopic therapies. Hemostasis was achieved in all patients (100%). One patient (20%) developed recurrent bleeding 4 days after initial treatment. No complications or adverse events attributed to the cyanoacrylate application during the follow-up period of 57 days were observed. Application of cyanoacrylate is a safe and effective method to achieve immediate hemostasis when conventional endoscopic treatment is unsuccessful. This technique is easy to perform and should be considered in cases of patients with difficult-to-arrest acute non-variceal upper gastrointestinal bleeding.
authors.affiliation: Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kurek
authors.affiliation: Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Baniukiewicz
authors.affiliation: Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Swidnicka-Siergiejko
authors.affiliation: Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Dąbrowski
keywords: cyanoacrylate; endoscopic therapy; tissue adhesives