The efficacy of octreotide therapy in chronic bleeding due to vascular abnormalities of the gastrointestinal tract.
BACKGROUND
The treatment of angiodysplasia and watermelon stomach, vascular abnormalities implicated in gastrointestinal bleeding of obscure origin, is a major clinical problem.


OBJECTIVE
To determine the efficacy of octreotide in patients with long-standing gastrointestinal bleeding due to acquired angiodysplasia and watermelon stomach, resistant to previous treatments and not suitable for surgery because of old age and/or concomitant disorders.


METHODS
We treated 17 patients (seven had isolated angiodysplasia, seven had multiple upper and lower gastrointestinal angiodysplasia, and three had watermelon stomach) with octreotide (0. 1 mg subcutaneous t.d.s. for 6 months). Six of the patients had liver cirrhosis, one had Glanzmann-type platelet derangement, two had cardiovascular diseases and one had chronic uraemia.


RESULTS
Octreotide treatment stopped bleeding in 10 patients. A transient improvement was observed in four, who needed subsequent cyclical retreatment to correct low haemoglobin levels. No effect was observed in three, probably due to the severity of the concomitant disorders.


CONCLUSIONS
Octreotide is a safe drug that may be useful to control the recurrent gastrointestinal bleeding due to acquired angiodysplasia and watermelon stomach, especially in patients who are not candidates for surgery due to old age and/or concomitant disorders.
Nardone
G
G
Cattedra di Gastroenterologia, Università degli Studi 'Federico II', Naples, Italy. genardo@tin.it
Rocco
A
A
Balzano
T
T
Budillon
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000188:drug therapy / Q000209:etiology; D016888:Angiodysplasia / Q000150:complications / Q000188:drug therapy*; D002908:Chronic Disease; D004906:Erythrocyte Count; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000150:complications / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006452:Hemoglobinometry; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*
D005765:Gastrointestinal Agents; D007501:Iron; D015282:Octreotide