Successful Endoscopic Management of Non-Healing Perforated Duodenal Ulcer with Polyglycolic Acid Sheet and Fibrin Glue

Mishiro, Tsuyoshi; Shibagaki, Kotaro; Matsuda, Kayo; Fukuyama, Chika; Okada, Minoru; Mikami, Haruo; Izumi, Daisuke; Yamashita, Noritsugu; Okimoto, Eiko; Fukuda, N.; Aimi, Masahito; Fukuba, Nobuhiko; Oshima, Naoki; Takanashi, Toshihiro; Matsubara, Takeshi; Ishimura, Norihisa; Ishihara, Shunji; Kinoshita, Yoshikazu

doi:10.14309/crj.2016.170

Cited by 2 publications

(3 citation statements)

References 7 publications

(10 reference statements)

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“…Recently, in the field of gastrointestinal endoscopy, shielding for artificial ulcers after ESD for gastrointestinal neoplasms using PGA sheets with fibrin glue has also been reported [9, 10, 11]. In addition, the filling and shielding for peptic ulcer perforation and delayed perforation after ESD using PGA sheets have been reported [2, 3, 4]. PGA sheets serve as a scaffold function to induce better granulation formation for tissue regeneration.…”

Section: Discussionmentioning

confidence: 99%

“…Fibrin glue was applied using a spray tube through the channel of the endoscope. We did not fix the PGA sheets using additional endoclips, unlike previous reports of peptic ulcer perforation [2, 3]. The procedure time for filling and shielding using PGA sheets with fibrin glue took 20 min, and there were no adverse events.…”

Section: Case Reportmentioning

confidence: 99%

“…Surgical repair, usually with suturing of the defect and placement of either an omental patch or a round ligament from the liver, has been the mainstay for the management of peptic ulcer perforation [1]. Recently, a few researchers have reported cases in which gastric and duodenal ulcer perforations were closed endoscopically using polyglycolic acid (PGA) sheets with fibrin glue [2, 3]. In addition, Takimoto and Hagiwara [4] reported endoscopic treatment using PGA sheets with fibrin glue for postoperative gastric perforation of endoscopic submucosal dissection (ESD).…”

Section: Introductionmentioning

confidence: 99%

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Successful Endoscopic Closure Using Polyglycolic Acid Sheets with Fibrin Glue for Nonhealing Duodenal Ulcer with Perforation after Proton Beam Therapy of Liver Tumor

Watanabe

Hikichi

Nakamura

et al. 2018

Case Rep Gastroenterol

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We describe the first case of a nonhealing duodenal ulcer with perforation after proton beam therapy (PBT) of a liver tumor that was successfully treated endoscopically using polyglycolic acid (PGA) sheets with fibrin glue. A 69-year-old man received PBT for a liver tumor. Esophagogastroduodenoscopy (EGD) 3 months after PBT revealed a duodenal ulcer. A proton pump inhibitor was administered for 7 weeks, and the ulcer healed. Six months after the EGD, recurrence of the duodenal ulcer with perforation occurred. An emergency open surgery with placement of the omental patch was performed. However, 5 days after the surgery, because the EGD revealed a perforation site in the duodenal ulcer that was not closed, the conservative treatment was continued. Twenty-eight days after the surgery, EGD revealed that the perforation size had increased. Therefore, we conducted endoscopic closure therapy using PGA sheets with fibrin glue. Eleven days after the closure procedure, the EGD showed that the perforation site was filled with granulation tissue and was closed. Forty-nine days after the procedure, EGD revealed that the ulcer had healed. This endoscopic closure treatment was effective for a nonhealing duodenal ulcer with perforation after PBT of a liver tumor.

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