Nonsurgical closure of esophago-respiratory fistulas: role for the somatostatin analogue octreotide acetate?
Esophago-respiratory fistulas (ERF) do not close spontaneously and are uniformly fatal. A somatostatin analogue (octreotide acetate) was used in three consecutive patients to promote the closure of ERF. In 2 patients with esophageal cancer, treatment with octreotide acetate was associated with fistula closure in 30 and 46 days, respectively. In a third patient with virally-induced ERF, treatment was associated with improvement of the inflammation of the fistula before the patient's death from pulmonary aspiration after 40 days of treatment. These preliminary observations suggest that octreotide acetate treatment of ERF should receive further investigative scrutiny.
Nylen
E S
ES
Department of Medicine, Veterans Affairs Medical Center, Washington, DC 20422.
Hall
J L
JL
Krasnow
S H
SH
Becker
K L
KL
Wadleigh
R G
RG
D000368:Aged; D000369:Aged, 80 and over; D004937:Esophageal Fistula / Q000188:drug therapy* / Q000209:etiology; D004938:Esophageal Neoplasms / Q000150:complications; D006561:Herpes Simplex / Q000150:complications; D018259:Herpesvirus 1, Human; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D012137:Respiratory System
D015282:Octreotide