Visceral Perforation Following Hemostatic Powder TC-325 Application in a Patient With Gastric Cancer: A Case Report

Malignant tumors of the upper gastrointestinal (GI) tract are a common cause of GI bleeding, often presenting therapeutic challenges due to diffuse hemorrhage and poor visualization. Local hemostatic agents, such as TC-325 (Hemospray; Winston-Salem, NC: Cook Medical), have emerged as effective bridging therapies prior to definitive treatment. However, visceral perforation, though rare, is a serious complication associated with TC-325 use. We present a case of an 87-year-old male with metastatic gastric adenocarcinoma who experienced visceral perforation following TC-325 application for recurrent upper GI bleeding. Despite achieving initial hemostasis, the patient succumbed to complications of perforation. This study highlights the need for caution when using TC-325 in patients with advanced malignancies and friable tissue.