| Long-acting somatostatin analogue therapy in obscure-overt gastrointestinal bleeding in noncirrhotic portal hypertension: a case report and literature review. | |
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MedLine Citation:
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PMID: 19491695 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We describe a case of obscure gastrointestinal bleeding in a male with noncirrhotic portal hypertension who required multiple admissions and repeated blood transfusions over a 5-month period. Upper and lower gastrointestinal endoscopy failed to establish a cause for bleeding which was eventually ascribed to universal portal hypertensive stigmata in stomach, small bowel and colon, which were not amenable to endoscopic therapy. On account of extensive venous thrombosis, neither surgical shunting nor interventional radiology was an option. Initial management with prothrombotic agents failed. Our patient was successfully stabilized on long-acting somatostatin (SMS) analogue therapy using lanreotide, resulting in avoidance of further admissions and blood transfusion and restoration of his independence and quality of life. The use of short-acting SMS analogues is recognised in acute variceal haemorrhage secondary to portal hypertension in cirrhosis, and long-acting SMS analogue therapy has been described in obscure gastrointestinal bleeding though secondary to angiodysplasia. However, the potential role of long-term SMS analogues in noncirrhotic portal hypertensive bleeding of this type has not been reported earlier. This case supports its use in this scenario in the absence of surgical options and when only palliative approaches are available. |
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Authors:
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John M Hutchinson; Jason S R Jennings; Rebecca L Jones |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: European journal of gastroenterology & hepatology Volume: 22 ISSN: 1473-5687 ISO Abbreviation: Eur J Gastroenterol Hepatol Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-04 Completed Date: 2010-07-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9000874 Medline TA: Eur J Gastroenterol Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 754-8 Citation Subset: IM |
Affiliation:
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Department of Molecular Gastroenterology, Clinical Sciences Building, St. James's University Hospital, Leeds LS9 7TF, UK. johnmhutchinson@btinternet.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Esophageal and Gastric Varices
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drug therapy,
etiology Gastrointestinal Hemorrhage / diagnosis, drug therapy*, etiology Humans Hypertension, Portal / complications, drug therapy* Male Middle Aged Peptides, Cyclic / therapeutic use* Quality of Life Somatostatin / analogs & derivatives*, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Peptides, Cyclic; 118992-92-0/lanreotide; 51110-01-1/Somatostatin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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