Clin Mol Hepatol.  2013 Dec;19(4):417-420. 10.3350/cmh.2013.19.4.417.

Severe ischemic bowel necrosis caused by terlipressin during treatment of hepatorenal syndrome

• Kim HR
• Lee YS
• Yim HJ
• Lee HJ
• Ryu JY
• Lee HJ
• Yoon EL
• Lee SJ
• Hyun JJ
• Jung SW
• Koo JS
• Choung RS
• Lee SW
• Choi JH

• KMID: 1730888
• DOI: http://doi.org/10.3350/cmh.2013.19.4.417

Abstract

Terlipressin is a vasopressin analogue that is widely used in the treatment of hepatorenal syndrome or variceal bleeding. Because it acts mainly on splanchnic vessels, terlipressin has a lower incidence of severe ischemic complications than does vasopressin. However, it can still lead to serious complications such as myocardial infarction, skin necrosis, or bowel ischemia. Herein we report a case of severe ischemic bowel necrosis in a 46-year-old cirrhotic patient treated with terlipressin. Although the patient received bowel resection, death occurred due to ongoing hypotension and metabolic acidosis. Attention should be paid to patients complaining of abdominal pain during treatment with terlipressin.

Keyword

Terlipressin; Necrosis; Hepatorenal syndrome

MeSH Terms

Bilirubin/blood
Creatinine/blood
Electrocardiography
Fatal Outcome
Hepatorenal Syndrome/*drug therapy
Humans
Intestinal Mucosa/pathology
Intestines/surgery
Liver Cirrhosis/diagnosis/therapy
Lypressin/adverse effects/*analogs & derivatives/therapeutic use
Male
Middle Aged
Necrosis/*chemically induced/surgery
Tomography, X-Ray Computed
Vasoconstrictor Agents/*adverse effects/*therapeutic use
Bilirubin
Creatinine
Lypressin
Vasoconstrictor Agents