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  • Title: Octreotide in the management of postoperative enterocutaneous fistulas and stress ulcer bleeding.
    Author: Chen RJ, Fang JF, Chen MF.
    Journal: Am J Gastroenterol; 1992 Sep; 87(9):1212-5. PubMed ID: 1519586.
    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.
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