title: Extensive hemorrhagic erosive gastritis associated with acute pancreatitis successfully treated with a somatostatin analog.
abstract: In massive hemorrhage from acute gastric mucosal lesions, it is occasionally difficult to control the bleeding with nonsurgical therapy. We used the somatostatin analog, octreotide, which suppresses gastric and pancreatic function, to treat severe hemorrhagic erosive gastritis in a patient with acute pancreatitis. A 22-year-old man presented with epigastralgia and melena. Blood levels of pancreatitis markers were elevated. Computed tomography revealed diffuse enlargement of the pancreas, without fluid collection around the organ. An endoscopic examination showed extensive hemorrhagic erosions over almost the whole gastric mucosa. We diagnosed extensive hemorrhagic erosive gastritis with acute pancreatitis. A protease inhibitor (nafamostat mesilate 50 mg/day) and an H(2) receptor antagonist (famotidine 40 mg/day) were administered by injection for 6 days; the patient's serum and urine amylase levels fell, but the gastric erosions with hemorrhage were not attenuated. Octreotide was given subcutaneously, at a daily dose of 100 microg for 5 days, without famotidine administration. His melena disappeared, and the gastric erosions were markedly decreased. Administration of the somatostatin analog, octreotide, proved to be effective treatment in a patient with severe hemorrhagic erosive gastritis associated with acute pancreatitis.
authors.affiliation: Department of Surgery, Juntendo Izunagaoka Hospital, 1129 Nagaoka, Izunagaoka-cho, Tagata-gun, Shizuoka 410-2211, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Yabuki
authors.forename: Takeo
authors.initials: T
authors.lastname: Maekawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Satoh
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Tamasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maekawa
authors.forename: Keizo
authors.initials: K
authors.lastname: Kudoh
authors.forename: Eizaburo
authors.initials: E
authors.lastname: Aoki
mesh_terms: D000208:Acute Disease; D000328:Adult; D005756:Gastritis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D006474:Hemorrhagic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D015282:Octreotide / Q000627:therapeutic use*; D010195:Pancreatitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D006490:Hemostatics; D015282:Octreotide