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Hemospray hemostasis in bleeding diffusely ulcerated esophagus
Shou-Jiang Tang1, Pegah Hosseini-Carroll1, Telciane S Vesa1
1Division of Digestive Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Background And Aims:
Bleeding from diffuse esophageal ulcerations can be difficult to treat. Hemospray is a hemostatic powder, and its mechanism of hemostasis is thought to be through concentrating clotting factors and forming mechanical plugs on bleeding vessels.
Methods:
The authors present 3 consecutive cases of diffusely ulcerated esophagus with clinically significant bleeding. The first 2 cases failed conventional hemostatic treatment including clipping and injection therapy. In the third case, Hemospray was used as the first-line monotherapy.
Results:
Immediate hemostasis was achieved in all 3 patients, and they did not develop recurrent bleeding for more than 2 months.
Conclusions:
The authors propose that Hemospray application should be considered as the first-line therapy in diffuse esophageal ulcerations with clinically significant bleeding, potentially reducing the need to repeat endoscopy. Once the Hemospray achieves hemostasis, it provides a cyto-protective barrier on the diffusely ulcerated mucosa against ongoing acid reflux, allowing the new tissue to grow more efficiently during the ulcer healing period.
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