Successful Use of Long‐Acting Octreotide for Intractable Chronic Gastrointestinal Bleeding in Children

O’Meara, Marie; Cicalese, Maria Pia; Bordugo, Andrea; Ambrosi, Alessandro; Hadžić, Nedim; Mieli‐Vergani, Giorgina

doi:10.1097/mpg.0000000000000540

Cited by 13 publications

(9 citation statements)

References 38 publications

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“…Octreotide therapy has been tolerated by patients and used safely in adults and children in safety studies for a variety of indications. [22][23][24][25][26][27][28][29] In addition, no serious adverse events were reported in this study of 12 patients treated with subcutaneous octreotide. The metabolic risks of prolonged chyle leak and the morbidity of other treatment options support the short-term use of octreotide in patients with postoperative chyle fistulas.…”

Section: Discussionmentioning

confidence: 98%

Use of Octreotide for the Management of Chyle Fistula Following Neck Dissection

Swanson

Hudson

Bhandari

et al. 2015

JAMA Otolaryngol Head Neck Surg

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In these patients, octreotide was safe and effective in resolving neck chylous fistulas. Octreotide therapy appears superior to traditional conservative measures of diet restriction and pressure dressings when compared with literature rates. A prospective study is needed to confirm results, but octreotide therapy should be considered as first-line conservative management for neck chyle fistulas that occur after neck surgery.

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Section: Discussionmentioning

confidence: 98%

Use of Octreotide for the Management of Chyle Fistula Following Neck Dissection

Swanson

Hudson

Bhandari

et al. 2015

JAMA Otolaryngol Head Neck Surg

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“…Se ha reportado el uso de las presentaciones del OCT-LAR, inicialmente diseñadas para su uso diario subcutáneo 14 y más recientemente para su administración intramuscular mensual 15 , en pacientes adultos cirróticos como adyuvantes en el tratamiento de várices debido a su acción en la disminución de la presión portal y la mejora de la hiperemia esplénica. En los últimos años, la administración intramuscular mensual de OCT-LAR ha sido indicada en pacientes adultos y en un pequeño grupo de pacientes pediátricos con HDA secundaria a HTP o con malformaciones vasculares [10][11][12][13] . En pacientes adultos, el tratamiento y prevención de la HDA secundaria a HTP incluye endoscopía, derivación portosistémica intrahepática transyugular o terapia farmacológica con análogos de la somatostatina en caso de episodios de sangrado o con beta bloqueadores como tratamiento profiláctico.…”

Section: Discussionunclassified

“…En los últimos años, se ha estado utilizando una presentación de OCT-LAR para la administración intramuscular mensual en pacientes adultos y pediátricos con HDA secundaria a HTP o con malformaciones vasculares. Se han reportado diversos efectos adversos por el uso de octreótido como nauseas, calambres abdominales, diarrea, hipoglucemia, problemas de crecimiento y desarrollo de cálculos biliares 10,13 . Existe una falta de evidencia en pediatría para tratar a los pacientes con HTP y HDA con sitios de sangrado ectópicos o no identificados.…”

Section: Introductionunclassified

Long-acting Release Octreotide for Pediatric Upper Gastrointestinal Bleeding

et al. 2020

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Introducción: La hemorragia digestiva por hipertensión portal, sin alternativa de tratamiento endoscópico o quirúrgico por localizaciones ectópicas, no identificadas del sitio de sangrado o características anatómicas, constituye un desafío terapéutico en Pediatría. El tratamiento habitual incluye la infusión de octreótido endovenoso. En los últimos años, la presentación de octreótido de liberación prolongada (OCT-LAR) para administración mensual intramuscular, resulta una alternativa terapéutica atractiva.Objetivo: Reportar el caso de un lactante con hemorragia digestiva por hipertensión portal que recibió tratamiento exitoso con OCT-LAR.Caso Clínico: Paciente de 8 meses de vida, con malformación de vena porta extrahepática y episodios reiterados de sangrados digestivos con requerimientos transfusionales e infusiones de octréotido, sin posibilidad de tratamiento endoscópico o quirúrgico. Indicamos OCT-LAR intramuscular mensualmente. Después de diez meses de iniciado el tratamiento, el paciente no repitió sangrados digestivos y no presentó efectos adversos relacionados a la medicación.Conclusión: Consideramos que el reporte de este caso puede resultar de utilidad al presentar una nueva alternativa para el tratamiento de pacientes pediátricos con sangrado digestivo por hipertensión portal sin posibilidades terapéuticas convencionales.

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“…11 Although the use of octreotide in children is currently off-label, it is being increasingly used in several GI conditions, such as pancreatitis, diarrhea, esophageal varices, and acute and chronic gastrointestinal bleeding. 12,13 The use of octreotide in newborns has also increased over the past decade. The most common indication is chylothorax 7 as, by decreasing intestinal fat absorption, octreotide contributes to the reduction of lymphatic flow in the thoracic duct.…”

Section: Discussionmentioning

confidence: 99%

Octreotide in a Critically Ill Extremely Preterm Infant With Perforated Necrotizing Enterocolitis

et al. 2016

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Necrotizing enterocolitis (NEC) is the most severe gastrointestinal complication of prematurity. Surgery, either peritoneal drainage placement or laparotomy with resection of the intestinal necrotic tracts, is the definitive treatment of perforated NEC; however, when clinical conditions contraindicate surgical approaches, little is known about medical treatments adjuvant or alternative to surgery. Octreotide is a synthetic somatostatin analog that inhibits pancreatic secretion and leads to splanchnic vasoconstriction. In preterm neonates, it is mainly used off-label for chylothorax and congenital hyperinsulinism, whereas gastrointestinal indications are limited. We describe the case of a critically ill extremely low birth weight infant with perforated NEC, who had unsuccessfully undergone peritoneal drainage placement and laparotomy. Her unstable condition contraindicated a further laparotomy, thus off-label treatment with octreotide was attempted. No adverse events occurred. The infant’s condition gradually improved and progressive reduction of peritoneal outputs and successful resolution of pneumoperitoneum were achieved, with no relapse after octreotide discontinuation.

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Successful Use of Long‐Acting Octreotide for Intractable Chronic Gastrointestinal Bleeding in Children

Cited by 13 publications

References 38 publications

Use of Octreotide for the Management of Chyle Fistula Following Neck Dissection

Use of Octreotide for the Management of Chyle Fistula Following Neck Dissection

Long-acting Release Octreotide for Pediatric Upper Gastrointestinal Bleeding

Octreotide in a Critically Ill Extremely Preterm Infant With Perforated Necrotizing Enterocolitis

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