2011 Volume 31 Issue 5 Pages 815-818
A 62-year-old man experienced bleeding from a gastric ulcer and hemostasis was achieved via a fiberscope. Four days later, however, he underwent an emergency operation due to rebleeding. His gastric ulcer had penetrated to the pancreatic head. We performed a distal gastrectomy and we could stop the bleeding with simple pressure. On the 9th postoperative day, however, he once again required an emergency operation due to hemoperitoneum. Arterial bleeding existed from pancreas head which failed to respond to simple pressure. Suturing was not an option, because the pancreatic tissue was fragile due to penetration of the gastric ulcer. We presumed that IVR was difficult because the catheter was unable to reach the small pancreaticartery. The patient could not undergo a pancreato-duodenectomy because he was in shock. We tried stop the bleeding using oxidized regenerated cellulose and fibrin glue followed by fibrin glue and polyglycolic acid felt. We finally achieved complete hemostasis with these bioadhesives. We report on the present case with a review of the relevant literature.
