A case of recurrent gastrointestinal bleeding and protein-losing gastroenteropathy.

A case of recurrent gastrointestinal bleeding and protein-losing gastroenteropathy.

Nat Clin Pract Gastroenterol Hepatol. 2007 May
Herfarth H,
Hofstadter F,
Feuerbach S,
Jurgen Schlitt H,
Scholmerich J,
Rogler G.
Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC 27599, USA. hherf@med.unc.edu

BACKGROUND: A 40-year-old male with pentalogy of Fallot (a congenital heart defect with five anatomical components) presented with recurrent gastrointestinal bleeding. He had recently recovered from a heart operation, which was performed to reconstruct the right ventricular outflow tract.

INVESTIGATIONS: Laboratory tests and absorption tests, esophagogastroduodenoscopy, capsule endoscopy, human serum albumin scintigraphy, lymphoscintigraphy, CT and abdominal lymph-node histology.

DIAGNOSIS: Intestinal lymphangiectasia with concurrent protein-losing gastroenteropathy and recurrent gastrointestinal bleeding.

MANAGEMENT: Despite a low-fat diet and surgical suturing of multiple small-bowel ulcerations the gastrointestinal bleeding continued. Serum albumin levels remained very low and severe lymphedema occurred. Unfortunately, the patient developed severe sepsis and died of multiple organ failure.

PMID: 17476211 [PubMed - in process]