Use of cyanoacrylate glue as a rescue therapy of a duodenal diverticular rebleeding

摘要

An 81-year-old man was admitted to the hospital because of recurrent hematochezia and hemorrhagic shock. He had a history of alcohol-related cirrhosis (Child-Pugh score of B7) and hypertension. Laboratory findings revealed severe anemia (hemoglobin 6.1 g/dL). The patient was sent to the intensive care unit for hemodynamic stabilization. He received 7 units of packed red blood cells within the first 24 hours. An urgent upper endoscopy showed a giant diverticulum (diameter of about 4 cm) filled with a blood clot in the third duodenal portion (Fig. 1A, B). After irrigation, a pulsatile bleeding site on the diverticular bottom became evident.