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Don't Look Back and Spray! Risk of Endoscope Adhesion with Hemospray Application in Retroflexion in a Pediatric
Sarah T Edwards1,2, Diana G Lerner3, Moises Alatorre Jimenez1,2
1From the Division of Gastroenterology, Children's Mercy Kansas City, Kansas City, MO.
Insights
Hemospray effectively controls pediatric upper gastrointestinal bleeding (GIB) in emergencies. However, a case report highlights potential transient endoscope adherence, suggesting careful application technique is crucial for pediatric GIB management.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Hemostasis
- Gastrointestinal Bleeding Management
Background:
- Pediatric upper gastrointestinal bleeding (GIB) is a common reason for urgent endoscopy.
- Hemostatic powders like TC-325 (Hemospray) offer advantages in controlling acute bleeding.
- These agents may cover large areas and require less technical skill.
Abstract:
Although the vast majority of recognized pediatric upper gastrointestinal bleeding (GIB) resolves spontaneously, gastrointestinal hemorrhage is the most common indication for urgent or emergent therapeutic endoscopy in pediatric practice. The application of hemostatic powders, including TC-325 (Hemospray, Cook Medical, Winston-Salem, NC, USA), has shown considerable impact on the control of acute bleeding, with the advantage of potentially covering an extensive area and requiring less technical expertise. We report a case of transient adherence of an esophagogastroduodenoscopy following Hemospray application in a 22-month-old with upper GIB. Our experience does not detract from the significant gains in the management of pediatric GIB from Hemospray; however, it does raise a cautionary note toward the application technique utilized.
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