Successful management of severe gastrointestinal bleeding from jejunal angiodysplasia in a patient with Bernard-Soulier syndrome

Vekaria, Pradip; Senthamizhselvan, Kuppusamy; Gnanasekaran, Senthil; Mohan, Pazhanivel

doi:10.1136/bcr-2020-240374

BMJ Case Rep

2021

DOI: 10.1136/bcr-2020-240374

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Successful management of severe gastrointestinal bleeding from jejunal angiodysplasia in a patient with Bernard-Soulier syndrome

Pradip Vekaria

Kuppusamy Senthamizhselvan

Senthil Gnanasekaran

et al.

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Octreotide

2021

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Lack of efficacy: case reportA 57-year-old woman experienced lack of efficacy during treatment with octreotide for severe gastrointestinal bleeding from jejunal angiodysplasia.The woman, who had been diagnosed with Bernard-Soulier syndrome 4 years previously, presented to the emergency department due to melena, easy fatigability and dizziness for 2 days. She did not have haematemesis, abdominal pain, ascites or jaundice. She did not have any bleeding manifestation. Her personal history and family history were not contributory. On examination, she was drowsy, pale, tachycardic and hypotensive. Her abdomen examination was unremarkable, and digital rectal examination showed melenic stool staining. Her blood tests revealed severe anaemia and thrombocytopenia, with giant platelets on a peripheral smear. She received 2 units of packed RBCs. Her initial upper endoscopy, colonoscopy and CT abdominal angiogram did not reveal any abnormality. Video capsule endoscopy showed multiple brisk bleeding spots in the proximal jejunum. She received octreotide infusion [dosage not stated] initially. However, there was no response for over 72 hours, and her haemoglobin value did not improve. Consequently, a diagnostic laparoscopy and intraoperative enteroscopy was performed which revealed multiple ectatic cherry red spots in proximal jejunum, with active diffuse pin-point ooze.The woman underwent resection of proximal jejunum in the same sitting. Histopathological examination of the resected bowel confirmed the diagnosis of angiodysplasia. Her postoperative period was uneventful. She was discharged in a stable condition. Over the subsequent 2 years, she did not have further bleeding episodes.

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Octreotide

2021

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Anemia-Induced Bleeding in Patients with Platelet Disorders

Thakar

Gabarin

Gupta

et al. 2021

Transfusion Medicine Reviews

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Successful management of severe gastrointestinal bleeding from jejunal angiodysplasia in a patient with Bernard-Soulier syndrome

Cited by 2 publications

References 6 publications

Octreotide

Octreotide

Anemia-Induced Bleeding in Patients with Platelet Disorders

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