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Two for the price of one: a dual treatment benefit of long-acting octreotide in occult bleeding and diuretic intractable ascites
  1. Bee Leng Lee1,2,
  2. Jeff Turner1,
  3. Joanna Hurley1,
  4. John Green1,
  5. Neil Hawkes2,
  6. Ruth Alcolado2
  1. 1Department of Gastroenterology, Llandough Hospital, UK
  2. 2Department of Gastroenterology, Royal Glamorgan Hospital, UK
  1. Correspondence to Bee Leng Lee, Department of Gastroenterology, Royal Glamorgan Hospital, CF72 8XR, UK; beeleng{at}doctors.net.uk

Abstract

Transfusion-dependent anaemia and portal hypertension are recognised complications of hereditary haemorrhagic telangiectasia (HHT). The anaemia is a result of chronic bleeding from gastrointestinal telangiectasias, which are usually multiple and located throughout the gastrointestinal tract. As a result, treatment with argon plasma coagulation via gastroscopy and or colonoscopy is often insufficient to prevent ongoing blood loss. Portal hypertension in HHT occurs as a result of blood shunting between the hepatic artery and the portal vein within the liver. The somatostatin analogue octreotide has been used as a treatment for bleeding angiodysplasia; however, its possible role as a treatment for diuretic intractable ascites secondary to portal hypertension has not been previously established. The authors report a case that apparently illustrates a dual benefit of long-acting octreotide in the management of both occult bleeding and refractory ascites in a patient with HHT.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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