Malignant irreversible intestinal obstruction: the powerful association of octreotide to corticosteroids, antiemetics, and analgesics.
In the case of malignant intestinal obstruction, surgery often carries important mortality and morbidity risks, and feasibility is neither realistic nor reasonable. A total of 4 clinical cases of intestinal obstruction caused by advanced gastrointestinal cancers in their terminal phase are described. The association of analgesics, corticosteroids, antiemetics, and octreotide was effective to relieve symptoms of intestinal obstruction for the remaining lifetime. The insertion of a nasogastric tube was avoided in 3 of 4 cases. Death occurred 51, 56, and 64 days after clinical and radiological diagnosis of irreversible intestinal obstruction. This combination of drugs appears very powerful and well tolerated. The relatively long survival that was observed should encourage future studies of longer half-life somatostatin analogues with no need of continuous infusion or multiple daily injections.
Weber
Catherine
C
Department of Rehabilitation and Geriatrics, Service of Palliative Medicine, University Hospitals of Geneva, Collonge-Bellerive, Switzerland.
Zulian
Gilbert B
GB
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D017809:Fatal Outcome; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D005770:Gastrointestinal Neoplasms / Q000150:complications; D006801:Humans; D007415:Intestinal Obstruction / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D011379:Prognosis; D013727:Terminal Care / Q000379:methods*; D019452:Terminally Ill
D000305:Adrenal Cortex Hormones; D000700:Analgesics; D005765:Gastrointestinal Agents; D015282:Octreotide