digitoxin and Gastrointestinal-Hemorrhage

A 60-year-old man under digitalis treatment for hypertensive heart tried to commit suicide by absorbing a 15 mg dose of digitoxin. Severe intestinal bleeding occurred 12 hours later, followed by pseudo-occlusive syndrome and ischaemia of the distal lower limbs. On abdominal incision the whole gut was found to be invaded by haemorrhagic necrosis and perforated on three points. The patients subsequently died of peritonitis. The responsibility of digitoxin in these events was demonstrated by the absence of any other cause of ischaemia, such as heart failure, shock, arrhythmia, consumption coagulopathy or use of sympathomimetic drugs. This case shows that the vasoconstrictor effect of digitalis, experimentally demonstrated but clinically controversial, is a reality, and that digitalis compounds are contra-indicated in patients with haemorrhagic necrosis of the digestive tract.

Topics: Digitalis Glycosides; Digitoxin; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Necrosis; Vasoconstrictor Agents

Topics: Aged; Aminorex; Anticoagulants; Digitoxin; Drug Evaluation; Drug-Related Side Effects and Adverse Reactions; Female; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Pulmonary Heart Disease

Topics: Aged; Digitoxin; Enterocolitis, Pseudomembranous; Female; Gastrointestinal Hemorrhage; Germany, West; Heart Failure; Humans; Infant, Newborn; Jejunum; Lanatosides

Topics: Adolescent; Adult; Aged; Aminobenzoates; Aminocaproates; Arthritis, Rheumatoid; Aspirin; Blood Coagulation Tests; Blood Platelets; Digitoxin; Dipyridamole; Female; Gastrointestinal Hemorrhage; Headache; Humans; Male; Middle Aged; Papaverine; Phenylbutazone; Platelet Adhesiveness; Spinal Osteophytosis; Streptokinase; Strophanthins; Thrombelastography

Topics: Chlorides; Digitalis; Gastrointestinal Hemorrhage; Geriatrics; Gluconates; Humans; Hydrochlorothiazide; Ileum; Intestinal Diseases; Intestinal Obstruction; Intestinal Perforation; Intestine, Small; Iron; Jejunum; Pathology; Potassium; Potassium Chloride; Quinidine; Reserpine; Tablets; Tablets, Enteric-Coated; Thiazides; Thyroid Hormones; Toxicology; Ulcer

Topics: Digitalis; Disease; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Intestinal Diseases; Intestines; Necrosis