Control of colonic variceal haemorrhage with a somatostatin analogue

Abstract

A 64 year old caucasian male with known alcoholic liver disease presented with rectal bleeding. The patient bled repeatedly despite resuscitation. A sigmoid colectomy was performed following an angiogram. Large colonic, rectal and mesenteric variceal vessels were noted at surgery. Further bleeding postoperatively was rapidly controlled with octreotide infusion. Octreotide may be as useful in the control of colonic variceal bleeding as it is in the control of oesophageal variceal bleeding.

How to Manage Gastric and Ectopic Varices?

“…Somatostatin or its analogue octreotide may be benefi cial and should be continued for 3-5 days after confi rmation of the diagnosis [ 72 ]. Octreotide has been shown to be effective in the control of bleeding colonic varices [ 73 ]. Terlipressin use should be considered but no defi nite recommendation for the dose or frequency of administration is available at present.…”

Endoscopic Management of Portal Hypertension

“…Initial management involves hemodynamic stabilization, use of vasoactive drugs and antibiotic prophylaxis [13]. Octreotide has been shown to be effective in the control of bleeding colonic varices [94]. …”

Right Sided Colonic Varices: 2 Cases and Review of the Literature

“…In transfusion dependent patients, medical, local or surgical therapy is reported. Portal decompression is appropriate in patients with portal hypertension, and has included: beta blocker [18,23] somatostatin infusion/ octreotide [23,27], vascular stenting (TIPS and portal vein stenting) [12,17,19] and heparine [8]. Local control therapy included: catheter embolization [16,19], cyanoacrylate infusion [19,22], argon plasma coagulation [21], and ligation [11,20].…”