Successful treatment of massive acute lower gastrointestinal bleeding in diverticular disease of colon, with activated recombinant factor VII (NovoSeven)

Recombinant coagulation factor (rFVIIa) (NovoSeven; Novo Nordisk A/S, Copenhagen, Denmark) is registered in most regions in the world for the treatment of bleeding episodes in haemophilia with inhibitors to factor VIII or factor IX. The mechanism of action suggests that its enhancing effects in haemostasis are limited to the site of injury and that systemic activation of the coagulation cascade does not occur. We report a case of lower gastrointestinal bleeding in diverticular disease of the colon in an inoperable elderly patient without pre-existing coagulopathy, which has successfully treated with a single injection of rFVIIa. This experience suggests that rFVIIa, besides its actual high costs, might be a useful and safe, noninvasive therapeutic tool in selected cases of massive lower gastrointestinal bleeding in the elderly.