title: Octreotide in the management of postoperative enterocutaneous fistulas and stress ulcer bleeding.
abstract: We report two clinical experiences in the treatment of postoperative enterocutaneous fistula and stress ulcer bleeding with octreotide acetate (Sandostatin). In both patients, upper gastrointestinal bleeding occurred 7 days after operation, and the bleeding proved to be stress ulceration, by panendoscopic examination. Enterocutaneous fistulas also were found in both patients. One was high output (750 ml/day), and the other was low output (50 ml/day). Octreotide 50-100 micrograms was given subcutaneously every 8 h. After three doses of octreotide, a significant reduction in fistula output and control of the stress ulcer bleeding were noted. The fistulas closed promptly after nine doses of octreotide, but the first patient's fistula recurred 2 days later, with fluid losses of about 100-200 ml/day. This fistula closed spontaneously 1 month after discharge. Octreotide appears to be useful as an adjunct to the conventional treatment of enterocutaneous fistulas, especially those complicated by stress ulcer bleeding.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
authors.forename: R J
authors.initials: RJ
authors.lastname: Chen
authors.forename: J F
authors.initials: JF
authors.lastname: Fang
authors.forename: M F
authors.initials: MF
authors.lastname: Chen
mesh_terms: D000368:Aged; D005260:Female; D005402:Fistula / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D010438:Peptic Ulcer Hemorrhage / Q000150:complications / Q000188:drug therapy*; D011183:Postoperative Complications / Q000188:drug therapy*; D012871:Skin Diseases / Q000150:complications / Q000188:drug therapy*; D013312:Stress, Physiological
chemical_list: D015282:Octreotide