Recent evidence suggests that parenteral
proton pump inhibitors (PPIs) can effectively control gastric acid hypersecretion. Intravenous PPI (
omeprazole) can substantially reduce the risk of recurrent
bleeding in patients with
peptic ulcer disease. We describe a patient with
short bowel syndrome who had recurrent life-threatening upper gastrointestinal
bleeding from severe gastric and esophageal ulcerations. The patient had failed long-term, maximal-dose intravenous
ranitidine therapy but was successfully treated and maintained on long-term
therapy with an intravenous PPI (
pantoprazole). To our knowledge, this is the first case report in the literature describing the use of an intravenous PPI to treat upper gastrointestinal
bleeding in a patient with complete intestinal resection. Intravenous PPIs should be considered as the first line of treatment of erosive
esophagitis and
peptic ulcer disease in patients with
short bowel syndrome and in patients who are nil per os and who fail intravenous H 2 -receptor antagonist treatment. Parenteral PPI may also be the drug of choice in
intensive care patients who have erosive
esophagitis. Furthermore, this is the first case report describing the novel use of intravenous
pantoprazole to treat erosive
esophagitis in a patient with
short bowel syndrome, suggesting that intravenous PPI may also be useful for the treatment of
ulcer prophylaxis in patients undergoing intestinal
transplantation.