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

Abstract

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.

• Authors: Hans Herfarth, Ferdinand Hofstädter, Stefan Feuerbach, Hans Jürgen Schlitt, Jürgen Schölmerich, Gerhard Rogler
• Journal: Nature clinical practice. Gastroenterology & hepatology (Nat Clin Pract Gastroenterol Hepatol) Vol. 4 Issue 5 Pg. 288-93 (May 2007) ISSN: 1743-4386 [Electronic] England
• PMID: 17476211 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Biopsy
• Diagnosis, Differential
• Diet, Fat-Restricted
• Digestive System Surgical Procedures
• Endoscopy, Gastrointestinal
• Fatal Outcome
• Gastrointestinal Diseases (complications, diagnosis, diet therapy)
• Gastrointestinal Hemorrhage (complications, diagnosis)
• Humans
• Jejunum (pathology)
• Lymphangiectasis, Intestinal (complications, diagnosis, surgery)
• Lymphedema (etiology)
• Male
• Multiple Organ Failure (etiology)
• Protein-Losing Enteropathies (complications, diagnosis, diet therapy)
• Radionuclide Imaging
• Recurrence