AANA Journal: Hemostatic Spray TC-325 (Hemospray®) and Unexpected Esophageal Entrapment of Gastroscope With Airway Management Considerations: A Case Report-AANA Journal: Hemostatic Spray TC-325 (Hemospray®) and Unexpected Esophageal Entrapment of Gastroscope With Airway Management Considerations: A Case Report

AANA Journal: Hemostatic Spray TC-325 (Hemospray®) and Unexpected Esophageal Entrapment of Gastroscope With Airway Management Considerations: A Case Report

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Pdf Summary

Upper gastrointestinal bleeding (UGIB) is a serious condition accounting for 2% of hospital admissions annually, with up to 17% mortality. Endoscopic interventions like Hemospray TC-325 are used to achieve hemostasis in nonvariceal UGIB cases. Hemospray, approved by the FDA in 2018, forms a mechanical tamponade by absorbing water and clotting factors at the bleeding site. While rare, adverse events like perforation and gastroscope entrapment can occur. A case report discussed a patient experiencing gastroscope entrapment in the esophagus post-Hemospray treatment, highlighting airway management challenges. Sedation by anesthesia providers during endoscopic procedures plays a vital role, but unexpected complications like gastroscope entrapment can impact airway management strategies.<br /><br />The case involved a 75-year-old patient with UGIB who underwent an esophagogastroduodenoscopy (EGD) treated with Hemospray, resulting in gastroscope entrapment. Prompt airway management was crucial, with considerations for ventilation and contingency plans to prevent airway compromise. The patient required fiber-optic bronchoscope assistance for gastroscope removal, ensuring patient safety and successful procedure completion. Lessons from the case underscore the importance of preparedness, equipment availability, and vigilance during endoscopic procedures, particularly with emerging technologies like Hemospray. Anesthesia providers need to be aware of potential complications, like gastroscope entrapment, and be equipped to handle unexpected airway challenges during endoscopic interventions.

Keywords

Upper gastrointestinal bleeding

UGIB

Hemospray TC-325

Endoscopic interventions

FDA approval

Mechanical tamponade

Adverse events

Gastroscope entrapment

Airway management

Anesthesia providers