Efficacy of a somatostatin analogue in a case of obscure gastrointestinal bleeding

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Gastrointestinal bleeding can have many reasons and therapy becomes tricky when the diagnostic workout is not conclusive. We describe the case of an 89 y.o. woman with severe anemia and gastrointestinal bleeding of an unknown origin after conventional imaging and endoscopic procedures, thus averting endoscopic, angiographic or surgical approach. This condition required 39 blood transfusions in 2 months. Subcutaneous Octreotide, reducing gastrointestinal mucosal perfusion, achieved hemodynamic stability, improved blood cell count, and ended the blood transfusions. The use of somatostatin analogues can be considered in refractory patients with digestive bleedings of an unknown origin not susceptible of first line therapy.