Spraying N-butyl-2-cyanoacrylate (Histoacryl) as a rescue therapy for gastrointestinal malignant tumor bleeding after failed conventional therapy.

gastrointestinal malignant tumors treated by spraying N-butyl-2-cyanoacrylate (Histoacryl) on the lesion with satisfactory results (●" Table 1). The first case was a 84-year-old man who presented with recurrent upper gastrointestinal bleeding since a few days. Esophagogastroduodenoscopy (EGD) revealed a 5-cm gastric cancer at the lesser curvature with oozing. Epinephrine (1 :20000) was injected into the tumor to slow down the bleeding, following which Histoacryl (cyanoacrylate 0.5mL with Lipiodol 0.8mL per aliquot) was sprayed via a 23-G needle catheter (InterjectTM, Boston Scientific, Massachusetts, USA) (●" Fig. 1) over the tumor surface, followed by sterile water until hemostasis was achieved. The patient had no overt bleeding at 9 weeks after the procedure. The second case was a 76-year-old woman with cryptogenic cirrhosis who presented with recurrent lower gastrointestinal bleeding. Colonoscopy revealed a 5-cm sessile polyp in the ascending colon with oozing. Epinephrine was injected and Histoacryl sprayed using the same technique as described above, and the bleeding stopped. The third case was a 15-year-old boy with a metastasizing germinoma with tumor invasion of the second portion of the duodenum. The bleeding was stopped using the same technique again. The patient had recurrent bleeding 48 h later, which was successfully stopped by angio-embolization. The fourth case involved a 56-year-old man with pancreatic Spraying N-butyl-2-cyanoacrylate (Histoacryl) as a rescue therapy for gastrointestinal malignant tumor bleeding after failed conventional therapy