Rectal amputation sparing by haemostatic therapy with recombinant factor VIIa in a patient with cytomegalovirus–related colitis

Abstract

C ytomegalovirus infection (CMV)isafrequent and dreadful complication affecting patients with acquired immunodeficiencysyndrome (AIDS), transplanted patients on immunosuppressive therapyasw ellasneoplastic patients after high-dosec hemotherapy(1-4). Gastrointestinal (GI) involvement in CMV infection maycausesevere complications suchas ulceration, perforation, stenosis and haemorrhage, particularly at the levelofthe colorectal tract (1, 5). CMV colitis is responsible for up to aquarter of GI bleeding in immunocompromised patients and asubstantial portion of such patients requiressurgeryaslast-ditchtreatment to control bleeding unresponsiveto adequatemedical supportand anti-viraltherapies(6-9). In this case reportw edescribe the use of recombinantactivatedfactor VII (rFVIIa; Novoseven, Novo Nordisk A/S,Bagsvaerd,Denmark)tocontrol asevere GI haemorrhage in apatient with aCMV-related ulcerativecolitis scheduled for an emergency rectal amputation.