Abstract

PEIXOTO, P. et al. O Cianoacrilato na Terapêutica Endoscópica de Úlceras Pépticas em Doentes de Alto Risco: a propósito de 8 casos. J Port Gastrenterol. [online]. 2009, vol.16, n.3, pp.101-108. ISSN 0872-8178.

Background/Study aims: Bleeding peptic ulcer is still the main cause of upper gastrointestinal haemorrhage. Several endoscopic haemostatic methods with similar efficacy are currently available. Cyanoacrylate is successfully used in variceal haemorrhage, however, its use is controversial in bleeding peptic ulcer. The authors present a study with endoscopic injection of cyanoacrylate for the treatment of haemorrhagic ulcers refractory to conventional endoscopic haemostasis in surgical high-risk patients. Patients and methods: Retrospective study based on the analysis of medical records of 8 patients (7 men, mean age 78 years), between January/2004-July/2006. End points: ongoing haemorrhage, rebleeding and mortality. Complications caused by endoscopic treatment were analised. Results: Ulcers location: 2 gastric, 5 duodenal, and 1 extensive ulcer with gastro-duodenal component; endoscopic stigmata (Forrest): 2 IA, 1 IB and 5 IIA. Cyanoacrylate was used in 3 (37.5%) patients due to ongoing bleeding and in 5 (62.5%) due to rebleeding. Haemostasis was successful in all patients. No rebleeding occurred. There were two embolic complications. The mortality rate was 12.5% (1 patient). Conclusions: Cyanoacrylate proved to be an effective haemostatic method for the treatment of bleeding peptic ulcer, although it has the potential to cause serious complications. It may be an alternative after failure of conventional endoscopic techniques in surgical high-risk patients.

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