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Introduction United States Food and Drug Administration recently approved use of Hemospray for the management of gastrointestinal (GI) Bleeding. We report our experience with Haemoseal Spray (HS, Shaili Endoscopy) for the treatment of upper GI bleeding (UGIB). Methods Records of patients who received HS for UGIB from January 2013 to June 2018 were studied retrospectively. Patients with UGIB from focal lesions refractory to conventional endotherapy or those with diffuse/multiple lesions not amenable to conventional endotherapy received 5cc HS spray. Primary end-point studied was clinical success, defined as control of bleeding over 24 hours. Secondary end-points evaluated included recurrence of bleeding within 7 days, in-hospital mortality, and complications secondary to HS. Results Thirty-eight patients were treated with HS. The median age was 57 (range: 5–87) years with 27 males and 11 females. In 24 patients, HS was used as monotherapy, while it was combined with Injection/Clip/Argon Plasma Coagulation in 14. Etiology of bleeding was ulcers or erosions in 22, malignancy in 10, portal hypertensive gastropathy/gastric antral vascular ectasia in 4, and radiation gastropathy in 2. Clinical success was achieved in 32/38 (84%). All six nonresponders had coagulopathy related to chemotherapy/bone marrow transplant. Recurrent bleeding within 7 days was observed in four patients (gastric malignancy 2, radiation gastropathy 2). In-hospital mortality was seen in 8/38 (21%) of which 2(4.8%) were directly related to ongoing GI bleeding. There was no procedure-related complication. Conclusion HS is an effective and safe tool in the endoscopic management of UGIB due to diffuse or multiple focal lesions or focal lesions refractory to conventional endotherapy.

Gastrointestinal (GI) bleeding due to jejunal diverticula is very rare. Capsule endoscopy is a useful diagnostic tool for localizing the bleeding site, but single‑balloon enteroscopy is a good therapeutic modality for the management. Here, we report two cases, in whom the cause of GI bleeding was jejunal diverticula and they managed successfully with endoscopic management.