Haemoseal Spray for Nonvariceal Gastrointestinal Bleeding: An Initial Experience from India

Abstract

Background and Aims: The aim was to reflect the use and effectiveness of Haemoseal spray as a treatment option in gastrointestinal (GI) bleed in everyday gastroenterology practice. Materials and Methods: This was a single‑center, retrospective observational study conducted over a period of 12 months from January 2016 to December 2016. Consecutive patients of upper or lower GI bleed where haemoseal powder was used either as salvage therapy after a failed hemostasis or as an add‑on to the standard methods or as monotherapy were identified and analyzed. Results: Of 284 patients with GI bleed, haemoseal spray was used in 20 (7.04%) patients. Bleeding was due to duodenal ulcer in 7 (35%), gastric ulcer 3 (15%), esophageal ulcer 2 (10%), colonic postpolypectomy bleed 2 (10%), gastric carcinoma 2 (10%), Mallory‑Weiss tear 1 (5%), postsphincterotomy bleed 1 (5%), gastric antral vascular ectasia 1 (5%), and portal hypertensive gastropathy 1 (5%). The nature of bleed was oozing in 17 (85%) and spurting in 3 (15%). Initial hemostasis when used as monotherapy was seen in 3/3, as add‑on therapy in 6/6, and as salvage therapy in 9/11 patients. Rebleed was seen in 4 (20%) and 30‑day mortality was seen in 2 (10%) patients. Rebleed rate at day 7 was more in monotherapy cases; however, the difference was not statistically significant (33.33% vs. 16.66% vs. 18.18%, P = 0.819). Conclusion: Haemoseal spray is an effective hemostatic agent in various clinical situations with GI bleeding, especially when used as salvage therapy or as add‑on therapy.

Keywords

• hemospray
• nonvariceal gastrointestinal bleeding
• refractory gastrointestinal bleeding