Figure 3. Hepatic AV malformation on doppler ultrasound
He was frequently hospitalized because of the severe anemia and high
output heart failure; received frequent blood transfusions and put on
diuretics and had nasal packing applied during episodes of nasal
bleeding. Due to ongoing gastrointestinal bleeding, he was transferred
to another hospital for endoscopic intervention where
electrocauterization (electro-ablation) of gastric and duodenal
telangiectasias was done, after which there was no drop in hemoglobin
and he did not require transfusion. He continued to have bouts of
massive epistaxis for which silver nitrate cauterization was done,
bleeding was arrested and septal dermoplasty was planned if any
recurrence.