Kurek Krzysztof, Baniukiewicz Andrzej, Swidnicka-Siergiejko Agnieszka, Dąbrowski Andrzej
Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Poland.
Wideochir Inne Tech Maloinwazyjne. 2014 Sep;9(3):489-93. doi: 10.5114/wiitm.2014.44169. Epub 2014 Jul 22.
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.
胃肠道出血是一种常见的医疗急症。尽管内镜治疗在控制非静脉曲张性上消化道出血方面有效，但在持续出血的情况下，需要进行放射学或外科干预。氰基丙烯酸酯用于治疗难治性非静脉曲张性上消化道出血的应用研究较少。我们描述了在传统内镜治疗失败后，使用氰基丙烯酸酯治疗急性非静脉曲张性胃肠道出血以止血的患者。尽管进行了传统内镜治疗，但仍有5例患者因持续出血（3例十二指肠溃疡、1例胃溃疡和1例胃Dieulafoy病）接受了氰基丙烯酸酯应用（注射和/或喷洒）治疗。所有患者（100%）均实现止血。1例患者（20%）在初始治疗后4天出现再次出血。在57天的随访期内，未观察到与氰基丙烯酸酯应用相关的并发症或不良事件。当传统内镜治疗失败时，应用氰基丙烯酸酯是实现即时止血的一种安全有效的方法。该技术操作简便，对于难治性急性非静脉曲张性上消化道出血患者应予以考虑。
