Severe ischemic bowel necrosis caused by terlipressin during treatment of hepatorenal syndrome.
Terlipressin is a vasopressin analogue that is widely used in the treatment of hepatorenal syndrome or variceal bleeding. Because it acts mainly on splanchnic vessels, terlipressin has a lower incidence of severe ischemic complications than does vasopressin. However, it can still lead to serious complications such as myocardial infarction, skin necrosis, or bowel ischemia. Herein we report a case of severe ischemic bowel necrosis in a 46-year-old cirrhotic patient treated with terlipressin. Although the patient received bowel resection, death occurred due to ongoing hypotension and metabolic acidosis. Attention should be paid to patients complaining of abdominal pain during treatment with terlipressin.
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Hae Rim
HR
Kim
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Young Sun
YS
Lee
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Hyung Joon
HJ
Yim
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Hyun Joo
HJ
Lee
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Ja Young
JY
Ryu
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Hyun Jung
HJ
Lee
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Eileen L
EL
Yoon
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Sun Jae
SJ
Lee
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Jong Jin
JJ
Hyun
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Sung Woo
SW
Jung
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Ja Seol
JS
Koo
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Rok Sun
RS
Choung
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Sang Woo
SW
Lee
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Jai Hyun
JH
Choi
D001663:Bilirubin / Q000097:blood; D003404:Creatinine / Q000097:blood; D004562:Electrocardiography; D017809:Fatal Outcome; D006530:Hepatorenal Syndrome / Q000188:drug therapy*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007422:Intestines / Q000601:surgery; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000628:therapy; D008236:Lypressin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000139:chemically induced* / Q000601:surgery; D000077585:Terlipressin; D014057:Tomography, X-Ray Computed; D014662:Vasoconstrictor Agents / Q000009:adverse effects* / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin; D003404:Creatinine; D001663:Bilirubin
Hepatorenal syndrome; Necrosis; Terlipressin