Spray coagulation as an alternative to argon plasma coagulation for bleeding portal hypertensive gastropathy

Electrosurgical thermoablative modalities are commonly used for endoscopic hemostasis in nonvariceal sources of GI bleeding. Argon plasma coagulation (APC) is a noncontact type of thermoablative technique often used for treatment of bleeding gastric antral vascular ectasias and portal hypertensive gastropathy (PHG). However, its use depends on the availability of a dedicated APC unit, proprietary disposable probes, and the argon gas itself. This became a limitation in case of a 49 year old man with ethanol related cirrhosis of liver, who presented with diffusely bleeding PHG. In this situation, we did not have argon at hand, and improvised with an alternative technique of spray coagulation to successfully achieve hemostasis. Spray coagulation can potentially be used as an alternative to APC in mucosal bleeding.