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Novel treatment (new drug/intervention; established drug/procedure in new situation)
Long-time octreotide in an adolescent with severe haemorrhagic gastrointestinal vascular malformation
  1. Carl Friedrich Classen1,
  2. Dieter Haffner2,
  3. Christina Hauenstein3,
  4. Ricarda Wolf4,
  5. Ulrike Kyank2
  1. 1Oncology Haematology Department, University Childrens Hospital, Rostock, Germany
  2. 2General Pediatrics Department, University Childrens Hospital, Rostock, Germany
  3. 3Department for Diagnostic and Interventional Radiology, Institute for Radiology, Rostock, Germany
  4. 4Division of Gastroenterology, Department of Internal Medicine, University of Rostock, Rostock, Germany
  1. Correspondence to Dr Carl Friedrich Classen, cfclassen{at}gmx.de

Summary

Gastrointestinal vascular malformations are a rare cause of acute or chronic blood loss. Usually they are treated by endoscopic obliteration or surgical resection. When such a therapy is inapplicable, pharmacotherapy may be required. At the age of 15 years, our female patient suffered from transfusion dependent recurrent gastrointestinal haemorrhage due to multiple gastrointestinal vascular malformations. Gastroscopy, coloscopy and capsule endoscopy revealed numerous foci making both endoscopic obliteration and complete surgical resection impossible. Neither regular transfusions nor substitution with coagulation factors were helpful. However, subcutaneous octreotide resulted in immediate stop of bleeding. Initial treatment by daily subcutaneous injections was followed by monthly depot application. Over 3 years only 2 transfusions had to be given. The patient required thyroxin substitution, otherwise, no side effects occurred and the girl had a good quality of life. The authors conclude that octreotide is safe and effective in gastrointestinal angiodysplasias inaccessible to endoscopy or surgery.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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