Esophagus, Stomach & Intestine; Hemostatic Effect of Histoacryl for Band: induced Esophageal Ulcer Bleeding

Kim, Young Soo; Cho, Sung Won; Hahm, Ki Baik; Kim, Jin Hong; Hong, Sa Joon; Moon, Young Soo; Lee, Kwang Jae

Abstract

BACKGROUND/AIMS
Endoscopic variceal ligation(EVL) is a method to manage esophageal varices bleeding and induces mechanical ligation and strangulation of varices by using elastic O-rings. The lower complication rate seen with EVL compared to sclerotherapy can be explained by the more limited degree of local tissue injury induced by EVL. Only the mucosal and submucosal layers are aspirated into cylinder attachment of the ligating devices, thus limiting injury to these layers. But, sometimes band induced ulcer shows massive bleeding. In these cases, endoscopic therapy is very difficult. This study was performed in order to find out the effectiveness of Histoacryl ingection for band-induced esophageal ulcer bleeding,
METHODS
We tried to control band-induced bleeding by injecting Histoacryl in 8 cases of band-induced ulcer bleeding.
RESULTS
This therapeutic trials show exellent control of bleeding in all cases without rebleeding.
CONCLUSIONS
The cyanoacrylate tissue adhesive Histoacryl(N-butyl-2-cyanoacrylate) is a remarkable substance that transforms from its original liquid state into a solid state when mixed with a physiologic medium such as blood. Histoacryl undergoes an instantaneous polymerization reaction and hardens, thereby plugging the varix or bleeding vessel lumen. Rapid hemostasis of an active bleeding occurs and rebleeding of the treated lesion is prevented. We found out that Histoacryl injection is a safe and effective treatment for band-induced ulcer bleeding.