Improvement of the treatment of gastrointestinal bleeding (GIB) by the use of EndoClot hemostatic powder

Gastrointestinal bleeding (GIB) can be due to a plethora of disease, such as ulcers and liver cirrhosis or can occur as result of iatrogenic interventions such as polypectomy. GIB is still a demanding indication for GI endoscopy with high morbidity and mortality rates. To further increase the endoscopist's armament, hemostatic powders such as EndoClot have been developed. In this study, we evaluated the application of EndoClot during routine and emergency endoscopy during a one year period.

EndoClot was used in twenty-four endoscopies in twenty patients (1.2 per patient), with seventeen applications (70,8%) in upper and seven (29,1%) in lower GI endoscopy.

In nine cases (37,5%), EndoClot was used as salvage therapy, after other interventions (injection with epinephrine, clip application) failed, with bleeding stop in all cases (100%) and no further rebleeding.

In four cases (16.6%), EndoClot was used as first time measure in patients with an impaired coagulation system with immediate bleeding stop in 3 of 4 cases (75%).

In nine cases (37.5%) in the upper and five cases (20.8%) in the lower GI tract, EndoClot was applied prophylactically after initially achieved hemostasis. In both of the latter groups, each one re-bleeding (11.1 and 20.0%) occurred within 24 hours. These two bleedings could be terminated by further endoscopic interventions. No long term re-bleedings occurred.

One fatality (1/20 pts. 5%) occurred due to further diseases, not related to GIB. We observed no complication after EndoClot application.

EndoClot is a further and safe option for the treatment in GI endoscopy with cessation of bleeding in 75 – 100%. It can be used as first line therapy in coagulation disorders, after failure of other hemostatic options, or prophylactically after endoscopic resections.