Hereditary Hemorrhagic Telangiectasia with Intestinal Bleeding

Abstract

Summary 1.A case is reported of severe intractable hemorrhage due to hereditary hemorrhagic telangiectasia involving the ileum and jejunum, and requiring the transfusion of 86 pints of whole blood in 84 days to effect survival during efforts at hemostasis. 2.The usual agents which are supposed to affect capillary permeability and coagulation, rutin, vitamin C, vitamin K, and moccasin venom, were used in maximum doses to no avail. 3.Topical thrombin, 5,000 units every 8 hours, instilled into the duodenum was followed by immediate and striking improvement with cessation of bleeding after five days, without recurrence now for six months. 4.The use of topical thrombin in cases of hemorrhage from the upper G.I. tract is discussed, and the probable mechanism of action in this case is postulated.