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Crohn's Disease · Journal article
Den Open · August 27, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a case report of a 52-year-old man with Crohn's disease who experienced nine episodes of delayed bleeding after endoscopic stricturotomy of an ileo-sigmoid anastomotic stricture over 17 days. After failed hemostasis with forceps, synthetic peptide gel, endoscopic clips, and infliximab, wound coverage with polyglycolic acid sheets and fibrin glue prevented further bleeding and allowed discharge on post-procedure day 27.
Single case report. A 52-year-old man with Crohn's disease and ileo-sigmoid anastomotic stricture presenting for endoscopic stricturotomy. Patient had received infliximab 10 mg/kg every 8 weeks and oral 6-mercaptopurine 50 mg/day, and was not on antithrombotic drugs. Pre-procedure inflammatory biomarkers were normal.. Intervention: Endoscopic stricturotomy using an electrosurgical knife (IT-nano) with vertical and circumferential incisions, followed by endoscopic balloon dilation to 16 mm. After recurrent bleeding, polyglycolic acid sheets (NEOVEIL) and fibrin glue (…. n = 1. Hirosaki University Hospital, Aomori, Japan.
Patient experienced nine episodes of delayed bleeding on days 1, 3, 4, 6, 7, 9, 14, 15, and 17 after endoscopic stricturotomy Initial hemostatic measures (hemostatic forceps, biocompatible synthetic peptide gel, endoscopic clips) temporarily stopped bleeding but did not prevent recurrence Infliximab administered on post-ES day 7 was ineffective
Single case with no control or comparison group; cannot assess whether PGA sheet application was the specific cause of bleeding cessation versus time-dependent healing. No quantitative comparison to expected healing timelines or bleeding rates in similar cases; claimed as 'first report' but no systematic review of prior ES complications literature is provided.
This case suggests that polyglycolic acid sheets with fibrin glue may be a rescue option for intractable post-stricturotomy bleeding in Crohn's disease patients when standard hemostatic techniques fail. However, this is a single case and does not yet provide evidence sufficient to establish this as a standard practice; further cases or controlled studies would be needed to establish efficacy and safety.
A single case report describing a novel application of polyglycolic acid sheeting for a complication of endoscopic stricturotomy; no control group, no comparative data, and no quantitative evidence of efficacy beyond one patient's outcome.
As stated by the source record.
Quoted from the source exactly as published.
This case suggests that polyglycolic acid sheets with fibrin glue may be a rescue option for intractable post-stricturotomy bleeding in Crohn's disease patients when standard hemostatic techniques fail. However, this is a single case and does not yet provide evidence sufficient to establish this as a standard practice; further cases or controlled studies would be needed to establish efficacy and safety.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Endoscopic stricturotomy (ES) is a novel approach for treating benign strictures of the lower gastrointestinal tract. However, it is performed at a limited number of facilities, and strategies for preventing complications have not yet been established. We performed ES for ileo-sigmoid anastomosis associated with Crohn's disease (CD). Although endoscopic dilatation was successful, delayed bleeding occurred. Endoscopic hemostasis provided temporary relief, but delayed bleeding recurred nine times within 17 days after ES. Combined hemostatic treatments with vascular forceps soft coagulation, biocompatible synthetic peptide gel, and endoscopic clips failed to stop recurrent bleeding. Infliximab infusion was also unsuccessful. Finally, wound coverage with polyglycolic acid (PGA) sheets prevented rebleeding and avoided abdominal surgery. Here, we report that covering with a PGA sheet and fibrin glue may be useful in preventing recurrent delayed bleeding after ES for anastomosis associated with CD.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.