Published online Sep 16, 2014. doi: 10.4253/wjge.v6.i9.448
Revised: July 19, 2014
Accepted: August 27, 2014
Published online: September 16, 2014
Gastrointestinal bleeding can be a life-treating event that is managed with standard endoscopic therapy in the majority of cases. However, up to 5%-10% of patients may have persistent bleeding that does not respond to conventional measures. Several endoscopic treatment techniques have been proposed as strategies to control such cases, such as epinephrine injection, hemoclips or argon plasma coagulation, but there are certain clinical scenarios where it is difficult to achieve hemostasis even though adequate use of the available resources is made. Reasons for these failures can be associated with the lesion features, such as extent or location. The use of long-standing techniques in non-traditional scenarios, such as with cyanoacrylate for gastric varices sclerosis, has been reported with favorable results. Although new products such as TC-325 or Ankaferd Blood Stopper hemosprays may be useful, their formulations are not available worldwide. Here we present two clinical cases with very different scenarios of gastrointestinal bleeding, where the use of cyanoacrylate in spray had favorable results in uncommon indications. Cyanoacrylate used as a spray is a technique that can be used as an alternative method in emergent settings.
Core tip: Up to 5%-10% of patients with gastrointestinal bleeding may have persistent bleeding that does not respond to endoscopic measures. When failure of the initial management strategy is observed, new techniques can be used. Cyanoacrylate is a polymer that crystallizes upon contact with blood and, if used as a spray, can help achieve hemostasis with minimal or no risk to patients.