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Acute Gastrointestinal Bleeding in Olmesartan-Associated Collagenous Gastroduodenitis: A Potential Endoscopic

Rachel Hudacko1, Lance Siegel2

  • 1Orange Pathology Associates, PC, Department of Pathology, Orange Regional Medical Center, 707 East Main St., Middletown, NY 10940, USA.

Case Reports in Gastrointestinal Medicine
|May 8, 2018
PubMed

Insights

Olmesartan-associated collagenous gastroduodenitis can cause acute gastric bleeding during endoscopy. This rare condition involves collagen buildup in the stomach and duodenum, requiring careful endoscopic management.

Area of Science:

  • Gastroenterology
  • Pharmacology

Background:

  • Collagenous gastroduodenitis is a rare condition linked to olmesartan, an angiotensin II receptor antagonist used for hypertension.
  • Histological features include subepithelial collagen deposition, inflammation, and epithelial injury.
  • Endoscopic findings show inflamed, friable mucosa, potentially nodular or atrophic.

Observation:

  • A case of acute gastric bleeding occurred during direct mucosal contact in a patient undergoing endoscopy.
  • The patient had diagnosed olmesartan-associated collagenous gastroduodenitis.

Findings:

  • Direct mucosal contact during endoscopy can precipitate acute gastric bleeding in patients with collagenous gastroduodenitis.
  • This highlights a potential, previously underreported endoscopic complication.

Implications:

  • Awareness of this complication is crucial for endoscopists managing patients on olmesartan.
  • Careful endoscopic technique may be necessary to prevent bleeding in these patients.

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