Endoscopic Hemostasis of Upper Gastrointestinal Bleeding with Histoacryl: Last Resort Before Surgery

Abstract

Five patients presented with acute upper gastrointestinal bleeding, and underwent diagnostic and therapeutic endoscopy. The source of bleeding was identified in each case. Two patients had a large chronic gastric ulcer, one had a stress ulcer, one had a gastric ulcer with hypertrophic gastropathy, and one had a malignant infiltration of the second part of the duodenum. Conventional first-line therapeutic modalities failed to induce hemostasis in these bleeding lesions. Hemostasis was successfully achieved in each case using an endoscopic intralesional injection of Histoacryl. This agent may represent a last resort for endoscopic hemostasis before surgery.