Fibrin Glue for Bleeding Peptic Ulcers

Fibrin glue is a complex plasma-derived product formed by mixing human fibrinogen and human factor X111 with human thrombin and bovine aprotinin following virus inactivation. It has been used to treat bleeding peptic ulcer by injecting the material through a dual lumen endoscopy injection needle into the floor of the ulcer around the bleeding point. In experimental and uncontrolled studies in patients it appears effective and produces little tissue damage. A large randomized trial in 854 patients admitted because of bleeding peptic ulcer with active bleeding or non bleeding visible vessel at endoscopy suggests that repeated injection of fibrin tissue glue had a significantly lower rebleeding rate than single injection of the sclerosant polidocanol.