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Boletín Médico del Hospital Infantil de México
Article . 2016 . Peer-reviewed
License: CC BY NC ND
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Uso de Hemospray® en sangrado post-escleroterapia

Authors: Beatriz González Ortiz; Dora María Tapia Monge; Alicia Reyes Cerecedo; Oscar Hernández Mondragón;

Uso de Hemospray® en sangrado post-escleroterapia

Abstract

ResumenIntroducciónHemospray® es un nuevo dispositivo para hemostasia endoscópica utilizado para el sangrado gastrointestinal no variceal. Permite la hemostasia mediante la activación plaquetaria y el aumento de la concentración de factores de coagulación, así como la formación de una barrera mecánica sobre la pared de un vaso sangrante creando un tapón mecánico en el sitio de sangrado. Dentro de las principales indicaciones para su uso se encuentran lesiones de difícil acceso endoscópico, hemorragia gastrointestinal masiva, múltiples sitios de sangrado, modificación de la anatomía por terapia endoscópica previa, presencia de coagulopatía, dificultad para tener visualización directa o cuando es imposible tener contacto con la lesión sangrante. Sin embargo, su uso en niños aún no ha sido aprobado por la FDA. Existe un caso publicado de un paciente de 11 meses tratado exitosamente con Hemospray® por hemorragia gastrointestinal no variceal.Caso clínicoSe reporta el caso de una paciente de 2 años con falla hepática aguda y cirrosis biliar primaria con hipertensión portal y sangrado post-escleroterapia. Se analizó el caso para sustentar las nuevas terapias para el control del sangrado masivo en úlceras post-escleroterapia.ConclusionesLa aplicación demostró ser segura y sin efectos adversos. El uso de Hemospray® es una alternativa efectiva en el control del sangrado gastrointestinal.AbstractBackgroundHemospray® is a new device for endoscopic hemostasis used for non-variceal gastrointestinal bleeding. It enables hemostasis and platelet activation by increasing the concentration of clotting factors and forming a mechanical barrier on the wall of a bleeding vessel creating a mechanical plug at the site of bleeding. Within the main indications for use are: injuries with difficult endoscopic access, massive gastrointestinal bleeding, multiple bleeding sites, modification of the anatomy by previous endoscopic therapy, presence of coagulopathy, difficulty in having direct visualization or when it is impossible to have contact with the bleeding lesion. However, its use in children has not been approved yet by the FDA. There is a case report of an 11-month-old patient successfully treated with Hemospray® for non-variceal gastrointestinal bleeding.Clinical caseWe report the case of a 2-year-old female with acute liver failure and primary biliary cirrhosis with portal hypertension and bleeding after sclerotherapy. We analyzed the case to support new therapies for massive bleeding control in post-sclerotherapy esophageal ulcers.ConclusionsThe application showed to be safe without side effects. Using Hemospray® is an effective alternative in controlling gastrointestinal bleeding.

Keywords

Sangrado no variceal, No variceal bleeding, Pediatrics, RJ1-570, Úlcera post-escleroterapia, Hemospray®, Pediatrics, Perinatology, and Child Health, Public aspects of medicine, RA1-1270, Post-sclerotherapy esophageal ulcer, Niños, Children

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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Average
Average
Average
gold