Gastrointestinal Hemorrhage due to Large B-Cell Lymphoma Treated With Hemospray

Gastrointestinal bleeding (GIB) is a common cause of hospitalization and is associated with significant morbidity and mortality. The most frequent causes of nonvariceal upper GIB are peptic ulcers, mucosal erosions, Mallory-Weiss tears, and malignancy. Current endoscopic hemostatic methods, including injections, thermal and mechanical modalities, have a 5%-10% chance of recurrent bleeding. Hemospray (Cook Medical, Winston-Salem, NC, USA) is a recently approved modality and can help treat tumor-related GIB. We present a case of a patient with diffuse large B-cell gastric lymphoma who presented with tumor-related GIB. His clinical course was complicated by gastric perforation and active bleeding which was treated with Hemospray and over-the-scope clips (OTSC, Ovesco, Tubingen, Germany).