Modification of a hemostatic powder spray device for delivery through an incompatible endoscope

Hemostatic powder sprays are a valuable adjunct therapy in the management of gastrointestinal bleeds. Currently, available hemostatic powder spray delivery systems are designed for endoscopes with 2.8 mm operational channels. This limits their use in endoscopes with smaller operational channels designed for patients with atypical anatomy and small children. We report a case in which delivery of hemostatic spray was accomplished through a 2.2 mm working channel by way of after-market modification to the delivery system.