Reversible Ischemic Colitis After Intravenous Vasopressin Therapy

VASOPRESSIN reduces splanchnic blood flow, decreases portal pressure, and has been used in the treatment of bleeding esophageal varices.1Severe complications may arise from its use, in particular, myocardial and small-bowel ischemia.2We recently observed reversible ischemic colitis in a patient who received intravenous (IV) vasopressin for variceal hemorrhage. Report of a Case A 54-year-old man with alcoholic cirrhosis was admitted to the Hôpital Cantonal of Geneva because of hematemesis. There was no history of angina, claudication, or hypertension. The patient was conscious and oriented, with a pulse rate of 80 beats per minute and a blood pressure of 120/70 mm Hg. Hepatosplenomegaly was present without ascites. Bowel sounds were normal. Initial laboratory values included the following: hematocrit, 35%; leukocytes, 7,200/cu mm; platelets, 59,000/cu mm; prothrombin time, 14.2 s (control, 12 s); BUN, 18 mg/dL; sodium, 138 mEq/L; potassium, 4.3 mEq/L; chloride, 104 mEq/L; total serum bilirubin, 2.9