Haemostatic matrix for treating intra-collection bleeding after eus-drainage and endoscopic necrosectomy of a wopn in a cirrhotic patient

Abstract Text A 45-years-old male with alcoholic liver cirrhosis developed an infected WOPN(8.9 cm x 3 cm) filled with 90% of necrotic material, so EUS-drainage with a lumen apposing metal stent(10x20 mm) was performed followed by the first necrosectomy. A spurting bleeding suddenly occurred from a vessel of the wall during necrosectomy and haemostasis was immediately achieved by using a metal clip. At the fourth necrosectomy session, we achieved a complete cleaning of the cavity, but a wide area of the wall had an oozing bleeding, so we decided to apply a haemostatic agent into the cavity, next to the damaged wall, which immediately stopped to bleed. After further 48 hours we removed the LAMS.