1680 Endoscopic Cyanoacrylate Glue in an Actively Bleeding Gastric Tumor

Abstract

INTRODUCTION: 1 to 5 percent of upper gastrointestinal bleeds are due to tumors and it is not atypical for re-bleeding to occur. Most patients who experience severe hemorrhaging esophageal and gastric tumors die within 12 months. Currently, there are no well-defined guidelines regarding the implementation of cyanoacrylate glue in bleeding gastrointestinal tumors. Our primary aim is to demonstrate a novel technique for achieving hemostasis in an actively bleeding tumor. CASE DESCRIPTION/METHODS: A 55-year-old female with no documented past medical history presented with hematemesis. The patient experienced an acute drop of hemoglobin from 10 g/dl to 8 g/dl. The patient reported moderate alcohol use and denied use of NSAIDS. EGD was first performed and revealed a pulsating extravasating tumor. This was followed by the use of EUS to identify the bleeding vessel. Under EUS-guidance, cyanoacrylate glue was then precisely injected to achieve hemostasis. DISCUSSION: EUS-guided cyanoacrylate glue injection is a cost-effective therapy that may successfully achieve hemostasis in active tumor bleeds. It can serve as a primary method for hemostasis or when re-bleeding occurs. However, its potential for reduced rates of re-bleeding warrants further investigation. Watch the video: http://bit.ly/2YdnmbC.