Recurrent Obscure Gastrointestinal Bleeding: Dilemmas and Success with Pharmacological Therapies. Case Series and Review
The present article describes three difficult cases of recurrent bleeding from obscure causes, followed by a review of the pitfalls and pharmacological management of obscure gastrointestinal bleeding. All three patients underwent multiple investigations. An intervening complicating diagnosis or anti...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2009-01-01
|
| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/2009/862816 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832558094808252416 |
|---|---|
| author | Majid Almadi Peter M Ghali Andre Constantin Jacques Galipeau Andrew Szilagyi |
| author_facet | Majid Almadi Peter M Ghali Andre Constantin Jacques Galipeau Andrew Szilagyi |
| author_sort | Majid Almadi |
| collection | DOAJ |
| description | The present article describes three difficult cases of recurrent bleeding from obscure causes, followed by a review of the pitfalls and pharmacological management of obscure gastrointestinal bleeding. All three patients underwent multiple investigations. An intervening complicating diagnosis or antiplatelet drugs may have compounded long-term bleeding in two of the cases. A bleeding angiodysplasia was confirmed in one case but was aggravated by the need for anticoagulation. After multiple transfusions and several attempts at endoscopic management in some cases, long-acting octreotide was associated with decreased transfusion requirements and increased hemoglobin levels in all three cases, although other factors may have contributed in some. In the third case, however, the addition of low-dose thalidomide stopped bleeding for a period of at least 23 months. |
| format | Article |
| id | doaj-art-4b8dda8227b048819047a2149d7b9292 |
| institution | Kabale University |
| issn | 0835-7900 |
| language | English |
| publishDate | 2009-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology |
| spelling | doaj-art-4b8dda8227b048819047a2149d7b92922025-02-03T01:33:12ZengWileyCanadian Journal of Gastroenterology0835-79002009-01-0123962563110.1155/2009/862816Recurrent Obscure Gastrointestinal Bleeding: Dilemmas and Success with Pharmacological Therapies. Case Series and ReviewMajid Almadi0Peter M Ghali1Andre Constantin2Jacques Galipeau3Andrew Szilagyi4Division of Gastroenterology, Department of Medicine, Sir Mortimer B Davis Jewish General Hospital, Montreal, Quebec, CanadaDivision of Gastroenterology, Department of Medicine, Royal Victoria Hospital, Montreal, Quebec, CanadaDepartment of Radiology, McGill University School of Medicine, Montreal, Quebec, CanadaDivision of Hematology, Sir Mortimer B Davis Jewish General Hospital, McGill University School of Medicine, Montreal, Quebec, CanadaDivision of Gastroenterology, Department of Medicine, Sir Mortimer B Davis Jewish General Hospital, Montreal, Quebec, CanadaThe present article describes three difficult cases of recurrent bleeding from obscure causes, followed by a review of the pitfalls and pharmacological management of obscure gastrointestinal bleeding. All three patients underwent multiple investigations. An intervening complicating diagnosis or antiplatelet drugs may have compounded long-term bleeding in two of the cases. A bleeding angiodysplasia was confirmed in one case but was aggravated by the need for anticoagulation. After multiple transfusions and several attempts at endoscopic management in some cases, long-acting octreotide was associated with decreased transfusion requirements and increased hemoglobin levels in all three cases, although other factors may have contributed in some. In the third case, however, the addition of low-dose thalidomide stopped bleeding for a period of at least 23 months.http://dx.doi.org/10.1155/2009/862816 |
| spellingShingle | Majid Almadi Peter M Ghali Andre Constantin Jacques Galipeau Andrew Szilagyi Recurrent Obscure Gastrointestinal Bleeding: Dilemmas and Success with Pharmacological Therapies. Case Series and Review Canadian Journal of Gastroenterology |
| title | Recurrent Obscure Gastrointestinal Bleeding: Dilemmas and Success with Pharmacological Therapies. Case Series and Review |
| title_full | Recurrent Obscure Gastrointestinal Bleeding: Dilemmas and Success with Pharmacological Therapies. Case Series and Review |
| title_fullStr | Recurrent Obscure Gastrointestinal Bleeding: Dilemmas and Success with Pharmacological Therapies. Case Series and Review |
| title_full_unstemmed | Recurrent Obscure Gastrointestinal Bleeding: Dilemmas and Success with Pharmacological Therapies. Case Series and Review |
| title_short | Recurrent Obscure Gastrointestinal Bleeding: Dilemmas and Success with Pharmacological Therapies. Case Series and Review |
| title_sort | recurrent obscure gastrointestinal bleeding dilemmas and success with pharmacological therapies case series and review |
| url | http://dx.doi.org/10.1155/2009/862816 |
| work_keys_str_mv | AT majidalmadi recurrentobscuregastrointestinalbleedingdilemmasandsuccesswithpharmacologicaltherapiescaseseriesandreview AT petermghali recurrentobscuregastrointestinalbleedingdilemmasandsuccesswithpharmacologicaltherapiescaseseriesandreview AT andreconstantin recurrentobscuregastrointestinalbleedingdilemmasandsuccesswithpharmacologicaltherapiescaseseriesandreview AT jacquesgalipeau recurrentobscuregastrointestinalbleedingdilemmasandsuccesswithpharmacologicaltherapiescaseseriesandreview AT andrewszilagyi recurrentobscuregastrointestinalbleedingdilemmasandsuccesswithpharmacologicaltherapiescaseseriesandreview |