Breakthrough Advancement! Novel Hemostatic Gel Offers New Solution for Duodenal Diverticular Hemorrhage
A clinical case report published in the Endoscopyjournal in 2025 has brought a significant breakthrough in the treatment of the challenging condition of periampullary duodenal diverticular hemorrhage. For the first time, the novel self-assembling peptide hemostatic gel PuraStat was successfully used to achieve hemostasis in a case of duodenal diverticular bleeding, providing a novel approach for emergency endoscopic treatment.
Endoscopic hemostasis for bleeding from periampullary duodenal diverticula has long faced severe challenges. Blood pooling significantly obscures the visual field, making endoscopic procedures extremely difficult. Some patients have no choice but to undergo more invasive interventions like interventional radiology or surgery. PuraStat, produced by the Japanese company 3-D Matrix, Ltd., is a novel hemostatic gel already applied in gastrointestinal bleeding treatment. This marks its first reported clinical use specifically for duodenal diverticular hemorrhage.
The report details a 75-year-old male patient on aspirin therapy who presented with hematemesis. Endoscopy revealed active venous hemorrhage from a diverticulum near the duodenal papilla, with rapid blood pooling. Due to the risk of perforation, conventional electrocautery was not feasible. The medical team first filled the diverticulum with 3 ml of PuraStat for initial hemostasis. Within minutes, the active bleeding was controlled, and the clarity of the visual field improved markedly, allowing identification of the exposed vessel. Subsequently, complete hemostasis was achieved by securing the vessel with a reopening clip, with no complications occurring.
This case fully demonstrates the notable advantages of PuraStat: it not only achieves rapid and effective hemostasis but also optimizes the endoscopic operative field. It is particularly suitable for scenarios with active bleeding where maintaining a clear visual field is difficult. The research team notes that PuraStat holds promise as a significant option for emergency endoscopic hemostasis of periampullary diverticular bleeding, providing clinicians with a safer and more precise therapeutic tool and reducing treatment risk and trauma for patients.
This study was conducted by the Department of Gastroenterology team at the Japanese Red Cross Omori Hospital. The findings provide valuable clinical evidence for innovative practices in the field of gastrointestinal bleeding treatment and highlight the immense application potential of novel biomaterials in precision medicine.
