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Hemostatic powder: a new ally in the management of postsphincterotomy bleeding.

ABSTRACT:

SUBMITTER: Baracat FI

PROVIDER: S-EPMC6031079 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Hemostatic powder: a new ally in the management of postsphincterotomy bleeding.

Baracat Felipe Iankelevich FI Tranquillini Caio Vinicius CV Brunaldi Vítor Ottoboni VO Baracat Renato R de Moura Eduardo Guimarães Hourneaux EGH

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20170805 11

PMID: 30027130

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Management of acute variceal bleeding using hemostatic powder.

Project description:Background and objectivesThis study aimed to test the safety and efficacy of Hemospray® for emergency control of acute variceal bleeding (AVB) due to portal hypertension in cirrhotic patients.Patients and methodsThis single-arm, prospective trial, conducted at two hospitals in Belgium and Egypt, included patients admitted to the emergency room with hematemesis and/or melena and known or suspected liver cirrhosis. All patients received urgent hemodynamic stabilization, octreotide (50 mcg bolus then 25 mcg/hour for 24 hours) and intravenous ceftriaxone (1 g/hour). Endoscopy to confirm AVB and Hemospray® application (if indicated) was performed within six hours of admission. Patients were kept under observation for 24 hours and underwent second endoscopy and definitive therapy (band ligation and/or cyanoacrylate injection in cases of gastric varices) the next day.ResultsThirty-eight patients were admitted for suspected AVB, and 30 of these had confirmed AVB (70% male; mean age 59.5 years (range, 32.0-73 years)). Child-Pugh class C liver disease was present in 53.4%. Esophageal varices were observed in 83.4% of patients, gastric varices in 10%, and duodenal varices in 6.6%. Spurting bleeding at the time of endoscopy was observed in 43.4%. One patient developed hematemesis six hours after Hemospray® application and underwent emergency endoscopic band ligation. No major adverse events or mortalities were observed during 15-day follow-up.ConclusionHemospray® application was safe and effective at short-term follow-up for emergency treatment of AVB in cirrhotic patients.

| S-EPMC4480536 | biostudies-literature

Massive small-bowel bleeding treated with hemostatic powder.