Taxane-Induced Upper Gastrointestinal Bleeding

Docetaxel is a taxane, which is a class of chemotherapy agent used in the treatment of multiple malignancies. It is known to have gastrointestinal side effects which can range from mild symptoms such as nausea and diarrhea to more severe complications such as neutropenic enterocolitis. In the current literature, taxanes have not been described to cause upper gastrointestinal bleeding and melena. Here, we present a case of a 54-year-old woman with breast cancer who developed dizziness, fatigue, and melena after receiving chemotherapy. Esophagogastroduodenoscopy revealed diffuse gastric erosions as well as ulceration and linear superficial lesions in the duodenum; biopsies from these sites showed taxane-induced toxicity. Her bleeding resolved with medical therapy and subsequent removal of docetaxel from her chemotherapy regimen. This case identifies upper gastrointestinal bleeding as a previously undescribed side effect of docetaxel therapy. Recent docetaxel use should be included in the differential diagnosis for upper gastrointestinal bleed, and diagnosis should lead to consideration of cessation of docetaxel or substitution with another chemotherapeutic agent.

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Massive upper gastrointestinal bleeding due to right hepatic artery pseudoaneurysm secondary to cholecystitis

Open Medicine ◽

10.2478/s11536-013-0204-3 ◽

2013 ◽

Vol 8 (5) ◽

pp. 665-668

Author(s):

K. Habib ◽

G. Williams

Keyword(s):

Gastrointestinal Bleeding ◽

Hepatic Artery ◽

Upper Gastrointestinal Bleeding ◽

Japanese Literature ◽

Biliary Tree ◽

Artery Pseudoaneurysm ◽

Right Hepatic Artery ◽

Hepatic Artery Pseudoaneurysm ◽

Upper Gastrointestinal Bleed ◽

Upper Gastrointestinal

AbstractA literature trawl reveals a substantial number of reports on true visceral aneurysms, including the hepatic artery, but only a handful of cases of visceral pseudoaneurysms. The ones in relation to the biliary tree are associated with previous gall bladder surgery and can result in significant gastrointestinal bleeding. There are more than 10 reported cases of cystic artery pseudoaneurysms but a thorough search revealed only two cases in English (1,2) and perhaps one in Japanese literature of right hepatic artery pseudoaneurysm secondary to cholecystitis presenting as massive upper gastrointestinal bleed. We present a probable fourth case in a 52 year old woman with classical clinical/biochemical picture, typical radiological appearance and who underwent successful interventional radiological treatment of this condition.

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A Study of Clinical and Endoscopic Profile of Acute Upper Gastrointestinal Bleeding

Kathmandu University Medical Journal ◽

10.3126/kumj.v12i1.13628 ◽

2015 ◽

Vol 12 (1) ◽

pp. 21-25 ◽

Cited By ~ 1

Author(s):

KR Dewan ◽

BS Patowary ◽

S Bhattarai

Keyword(s):

Gastrointestinal Bleeding ◽

Scoring System ◽

Upper Gastrointestinal Bleeding ◽

Medical Emergency ◽

Ulcer Disease ◽

Gastrointestinal Bleed ◽

Acute Upper Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleed ◽

Rockall Score ◽

Upper Gastrointestinal

Backgroud Acute Upper Gastrointestinal Bleeding is a common medical emergency with a hospital mortality of approximately 10 percent. Higher mortality rate is associated with rebleeding. Rockall scoring system identifies patients at higher risk of rebleed and mortality.Objective To study the clinical and endoscopic profile of acute upper gastrointestinal bleed to know the etiology, clinical presentation, severity of bleeding and outcome.Method This is a prospective, descriptive hospital based study conducted in Gastroenterology unit of College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal from January 2012 to January 2013. It included 120 patients at random presenting with manifestations of upper gastrointestinal bleed. Their clinical and endoscopic profiles were studied. Rockall scoring system was used to assess their prognosis.Result Males were predominant (75%). Age ranged from 14 to 88 years, mean being 48.76+17.19. At presentation 86 patients (71.7%) had both hematemesis and malena, 24 patients (20%) had only malena and 10 patients (8.3%) had only hematemesis. Shock was detected in 21.7%, severe anemia and high blood urea were found in 34.2% and 38.3% respectively. Upper Gastrointestinal Bleeding endoscopy revealed esophageal varices (47.5%), peptic ulcer disease (33.3%), erosive mucosal disease (11.6%), Mallory Weiss tear (4.1%) and malignancy (3.3%). Median hospital stay was 7.28+3.18 days. Comorbidities were present in 43.3%. Eighty six patients (71.7%) had Rockall score < 5 and 34 (28.3%) had >6. Five patients (4.2%) expired. Risk factors for death being massive rebleeeding, comorbidities and Rockall score >6.Conclusion Acute Upper Gastrointestinal bleeding is a medical emergency. Mortality is associated with massive bleeding, comorbidities and Rockall score >6. Urgent, appropriate hospital management definitely helps to reduce morbidity and mortality.Kathmandu University Medical Journal Vol.12(1) 2014: 21-25

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