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Case Reports
. 2023 Jul 30;15(7):e42712.
doi: 10.7759/cureus.42712. eCollection 2023 Jul.

Purastat as an Adjunct Treatment Option in Acute Esophageal Varices Bleeding: A Case Report

Imran H Hassan  1 , David Elphick  1 , Ammar Al-Rifaie  1
Affiliations
Case Reports

Purastat as an Adjunct Treatment Option in Acute Esophageal Varices Bleeding: A Case Report

Imran H Hassan et al. Cureus. .

Abstract

Esophageal varices are dilated submucosal esophageal veins that connect the portal and systemic circulations. Bleeding esophageal varices is a well-recognized complication of liver cirrhosis.It is known that in active variceal bleeding, treatment needs to be started promptly. Treatments comprise band ligation, sclerotherapy, removable stent placement, balloon tamponade, and transjugular intrahepatic portosystemic shunt (TIPS).We report a case in which hemodynamic stability can be maintained with the use of Purastat to control bleeding.

Keywords: acute gastrointestinal bleed; cirrhosis liver; complications of cirrhosis; esophageal varices; purastat®.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The initial EGD showing four columns of grade 2 esophageal varices with multiple red signs (blue arrows depicting the four columns)
EGD, esophagogastroduodenoscopy
Figure 2
Figure 2. EGD for elective variceal banding. (A) Active bleeding from varices despite banding. (B) Successful resolution of bleeding after Purastat application
EGD, esophagogastroduodenoscopy
Figure 3
Figure 3. Repeat EGD two weeks later. (A) Post-banding ulcers with no active bleeding (arrow shows previous bleeding source). (B) Close-up of a post-banding ulcer
EGD, esophagogastroduodenoscopy
Figure 4
Figure 4. Follow-up EGD after two months. (A) Grade 1 esophageal varix. (B) Close-up of healed esophageal varix.
See this image and copyright information in PMC

References

    1. Management of acute variceal bleeding. Kim YD. https://doi.org/10.5946/ce.2014.47.4.308. Clin Endosc. 2014;47:308–314. - PMC - PubMed
    1. PuraStat in gastrointestinal bleeding: results of a prospective multicentre observational pilot study. Branchi F, Klingenberg-Noftz R, Friedrich K, et al. https://doi.org/10.1007/s00464-021-08589-6. Surg Endosc. 2022;36:2954–2961. - PMC - PubMed
    1. A case of gastric antral vascular ectasia in which PuraStat, a novel self-assembling peptide hemostatic hydrogel, was effective. Misumi Y, Takeuchi M, Kishino M, Kudo Y, Nonaka K. https://doi.org/10.1002/deo2.183 DEN open. 2022;3:0. - PMC - PubMed
    1. Endoscopically delivered Purastat for the treatment of severe haemorrhagic radiation proctopathy: a service evaluation of a new endoscopic treatment for a challenging condition. White K, Henson CC. Frontline Gastroenterol. 2021;12:608–613. - PMC - PubMed
    1. A novel fully synthetic and self-assembled peptide solution for endoscopic submucosal dissection-induced ulcer in the stomach. Uraoka T, Ochiai Y, Fujimoto A, et al. https://doi.org/10.1016/j.gie.2015.11.015. Gastrointest Endosc. 2016;83:1259–1264. - PubMed

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