Year 2024 / Volume 116 / Number 10
Letter
Delayed post-sphincterotomy bleeding: hemostatic powder is a safe and effective option

582-583

DOI: 10.17235/reed.2024.10161/2023

Mara Sarmento Costa, Andrea Silva, Luís Santos, Nuno Almeida, Dário Gomes, Pedro Figueiredo,

Abstract
We present the case of a 72-year-old woman admitted for epigastric pain, elevated inflammatory parameters and liver enzymes, with a total bilirubin of 6mg/dL. Abdominal ultrasound identified cholelithiasis and posteriorly endoscopic ultrasound showed a 5.8mm stone distally in the biliary tract. Due to acute cholangitis, she underwent endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy, successfully removing the stone. Mild self-limited bleeding after sphincterotomy was reported, for which an adrenaline flush of the biliary tract was performed. The following day, she presented melena and hemoglobin dropped 3g/dL, remaining hemodynamically stable. With side-viewing duodenoscopy we identified an adherent clot and an oozing bleed near the pancreatic duct opening. The clot was removed with a snare after adrenalin injection and 3 endoclips of 8mm were positioned in the superior portion of the sphincterotomy. Even then, bleeding persisted. We opted to apply hemostatic powder (Hemospray®) with successful bleeding cessation. Four days later the patient was released without bleeding recurrence or suspected biliary blockage.
Share Button
New comment
Comments
No comments for this article
References
1 - Law R, Cardenas A. Hemostatic Powder for Gastrointestinal Bleeding: Time to believe the hype or more false hope? Digestive and liver disease 2020;52:702–703. DOI: 10.1016/j.dld.2020.03.006.
2 - Falcão D, Ferreira D, Maia L, et al. Hemostatic spray as a therapy for pancreatic stump bleeding after cephalic duodenopancreatectomy. Rev Esp Enferm Dig 2023;115:456-457. DOI: 10.17235/reed.2022.9249/2022.
3 - Dumonceau JM, Kapral C, Aabakken L, et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2020;52:127–149. DOI: 10.1055/a-1075-4080.
4 - Baract FI, Tranquillini CV, Brunaldi VO, et al. Hemostatic powder: a new ally in the management of postsphincterotomy bleeding. VideoGIE 2017;2:303–304. DOI: 10.1016/j.vgie.2017.07.002.
Related articles

Digestive Diseases Image

Traumatic biliary fistula with bile duct disconnection

DOI: 10.17235/reed.2024.10096/2023

Letter

Hematoma post-endoscopic retrograde cholangiopancreatography

DOI: 10.17235/reed.2023.9670/2023

Digestive Diseases Image

Endosonographic and ERCP findings in COVID-19 critical illness cholangiopathy

DOI: 10.17235/reed.2022.9218/2022

Digestive Diseases Image

Colonic Kaposi’s sarcoma as the first clinical manifestation of undiagnosed HIV

DOI: 10.17235/reed.2022.8717/2022

Letter

A rare gastrointestinal tumor: primary gastric melanoma

DOI: 10.17235/reed.2022.8715/2022

Letter

Bochdalek hernia: use of capsule endoscopy

DOI: 10.17235/reed.2021.7760/2020

Digestive Diseases Image

Cholangiohydatidosis: an uncommon cause of acute cholangitis

DOI: 10.17235/reed.2020.7063/2020

Letter

Gastric ulcer due to mucormycosis in a critical patient

DOI: 10.17235/reed.2020.6636/2019

Letter

Obstructive jaundice of a parasitic etiology

DOI: 10.17235/reed.2018.5827/2018

Case Report

Appendicular bleeding: an excepcional cause of lower hemorrhage

DOI: 10.17235/reed.2015.3828/2015

Citation tools
Costa M, Silva A, Santos L, Almeida N, Gomes D, Figueiredo P, et all. Delayed post-sphincterotomy bleeding: hemostatic powder is a safe and effective option. 10161/2023


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 265 visits.
This article has been downloaded 10 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 11/12/2023

Accepted: 18/12/2023

Online First: 11/01/2024

Published: 09/10/2024

Article Online First time: 31 days

Article editing time: 303 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology