Skip to main content

Advertisement

SpringerLink
Log in

Octreotide and enterocutaneous fistula closure in neonates and children

  • Review
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Enterocutaneous fistula and its conservative management still pose a challenge for the surgeon. The use of octreotide and somatostatin in neonates and children as adjunctive therapy in the conservative management of this condition, leads to major controversy regarding its efficacy. Therefore, we conducted an extensive literature review of published articles regarding the use of somatostatin and its analogues in the treatment of enterocutaneous fistula in neonates and children. Our review is then presented together with a case vignette and discusses the different practical aspects of the treatment with these drugs.

Conclusion: The major diversity in treatment regimens among published studies makes outcomes difficult to compare. However, given the results of the different cases reported in the literature and of our own experience, we suggest a possible beneficial effect of octreotide and somatostatin on closure of enterocutaneous fistula in these patients.

What is Known:

• Enterocutaneous fistula in neonates and children is a very challenging condition.

• Treatment of enterocutaneous fistula still remains controversial.

What is New:

• Octreotide and somatostatin may play a role in the closure of enterocutaneous fistula.

• Our review will provide an updated source of information to guide management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

ECF:

Enterocutaneous fistula

GH:

Growth hormone

NEC:

Necrotising enterocolitis

O:

Octreotide

Pat:

Patient

SC:

Subcutaneous

S:

somatostatin

References

  1. Alivizatos V, Felekis D, Zorbalas A (2002) Evaluation of the effectiveness of octreotide in the conservative treatment of postoperative enterocutaneous fistulas. Hepatogastroenterology 49(46):1010–1012

    CAS  PubMed  Google Scholar 

  2. Al-Hussaini A, Butzner D (2012) Therapeutic applications of octreotide in pediatric patients. Saudi J Gastroenterol 18(2):87–94

    Article  PubMed Central  PubMed  Google Scholar 

  3. Alvarez C, McFadden DW, Reber HA (2000) Complicated enterocutaneous fistulas: failure of octreotide to improve healing. World J Surg 24(5):533–537, discussion 538

    Article  CAS  PubMed  Google Scholar 

  4. Arevalo RP, Bullabh P, Krauss AN, Auld PA, Spigland N (2003) Octreotide-induced hypoxemia and pulmonary hypertension in premature neonates. J Pediatr Surg 38(2):251–253

    Article  CAS  PubMed  Google Scholar 

  5. Bakhotmah MA (1996) Successful control of external biliary fistula by using SMS 201-995 in a child. HPB Surg 9(3):183–184

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Brazeau P, Vale W, Burgus R, Ling N, Butcher M, Rivier J, Guillemin R (1973) Hypothalamic polypeptide that inhibits the secretion of immunoreactive pituitary growth hormone. Science 179(4068):77–79

    Article  CAS  PubMed  Google Scholar 

  7. Budic I, Slavkovic A, Simic D, Djordjevic V, Novakovic D (2007) The role of octreotide in the treatment of pancreatic pseudocyst in pediatric patients: 10AP3-6. Eur J Anaesthesiol 24:133

    Article  Google Scholar 

  8. Büyükyavuz I, Karnak I, Yiğit S, Tanyel FC (2004) Successful treatment of enterocutaneous fistula in a premature newborn by using octreotide. Turk J Pediatr 46(3):289–291

    PubMed  Google Scholar 

  9. Dorta G (1999) Role of octreotide and somatostatin in the treatment of intestinal fistulae. Digestion 60(Suppl 2):53–56

    Article  CAS  PubMed  Google Scholar 

  10. Draus JM Jr, Huss SA, Harty NJ, Cheadle WG, Larson GM (2006) Enterocutaneous fistula: are treatments improving? Surgery 140(4):570–576, discussion 576-578

    Article  PubMed  Google Scholar 

  11. Dueno MI, Bai JC, Santangelo WC, Krejs GJ (1987) Effect of somatostatin analog on water and electrolyte transport and transit time in human small bowel. Dig Dis Sci 32(10):1092–1096

    Article  CAS  PubMed  Google Scholar 

  12. Fekete CN, Ricour C, Duhamel JF, Lecoultre C, Pellerin D (1978) Enterocutaneous fistulas of the small bowel in children (25 cases). J Pediatr Surg 13(1):1–4

    Article  CAS  PubMed  Google Scholar 

  13. Harris AG (1994) Somatostatin and somatostatin analogues: pharmacokinetics and pharmacodynamic effects. Gut 35(3 Suppl):S1–S4

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Heikenen JB, Pohl JF, Werlin SL, Bucuvalas JC (2002) Octreotide in pediatric patients. J Pediatr Gastroenterol Nutr 35(5):600–609

    Article  CAS  PubMed  Google Scholar 

  15. Hesse U, Ysebaert D, de Hemptinne B (2001) Role of somatostatin-14 and its analogues in the management of gastrointestinal fistulae: clinical data. Gut 49(Suppl 4):iv11–21

    PubMed Central  CAS  PubMed  Google Scholar 

  16. Hollington P, Mawdsley J, Lim W, Gabe SM, Forbes A, Windsor AJ (2004) An 11-year experience of enterocutaneous fistula. Br J Surg 91(12):1646–1651

    Article  CAS  PubMed  Google Scholar 

  17. Inamdar S, Slim MS, Bostwick H, Godine L (1990) Treatment of duodenocutaneous fistula with somatostatin analog in a child with dermatomyositis. J Pediatr Gastroenterol Nutr 10(3):402–404

    Article  CAS  PubMed  Google Scholar 

  18. Julia MV, Parri FJ, Albert A, Figueras J, Rovira J, Morales L (1989) Treatment of an enteric fistula with somatostatin in a premature. Clin Pediatr (Phila) 28(3):149–150

    Article  CAS  Google Scholar 

  19. Karabulut R, Karakuş C, Hirfanoğlu I, Turan O, Türkyilmaz Z, Sönmez K, Onal EE, Atalay Y, Başaklar AC (2008) Treatment of postoperative enterocutaneous fistulas with octreotide in two neonates. Eur J Pediatr Surg 18(1):56–58

    Article  CAS  PubMed  Google Scholar 

  20. Laje P, Halaby L, Adzick NS, Stanley CA (2010) Necrotizing enterocolitis in neonates receiving octreotide for the management of congenital hyperinsulinism. Pediatr Diabetes 11(2):142–147

    Article  PubMed  Google Scholar 

  21. Lam JC, Aters S, Tobias JD (2001) Initial experience with octreotide in the pediatric population. Am J Ther 8(6):409–415

    Article  CAS  PubMed  Google Scholar 

  22. Lamberts SW, van der Lely AJ, de Herder WW, Hofland LJ (1996) Octreotide. N Engl J Med 334(4):246–254

    Article  CAS  PubMed  Google Scholar 

  23. Leandros E, Antonakis PT, Albanopoulos K, Dervenis C, Konstadoulakis MM (2004) Somatostatin versus octreotide in the treatment of patients with gastrointestinal and pancreatic fistulas. Can J Gastroenterol 18(5):303–306

    PubMed  Google Scholar 

  24. Martinez JL, Luque-de-Leon E, Mier J, Blanco-Benavides R, Robledo F (2008) Systematic management of postoperative enterocutaneous fistulas: factors related to outcomes. World J Surg 32(3):436–443, discussion 444

    Article  PubMed  Google Scholar 

  25. Mohseni-Bod H, Macrae D, Slavik Z (2004) Somatostatin analog (octreotide) in management of neonatal postoperative chylothorax: is it safe? Pediatr Crit Care Med 5(4):356–357

    Article  PubMed  Google Scholar 

  26. Mosdell KW, Visconti JA (1994) Emerging indications for octreotide therapy, Part 1. Am J Hosp Pharm 51(9):1184–1192

    CAS  PubMed  Google Scholar 

  27. Mosdell KW, Visconti JA (1994) Emerging indications for octreotide therapy, Part 2. Am J Hosp Pharm 51(10):1317–1330

    CAS  PubMed  Google Scholar 

  28. Mulligan C, Howell C, Hatley R, Martindale R, Clark J (1995) Conservative management of pediatric pancreatic pseudocyst using octreotide acetate. Am Surg 61(3):206–209

    CAS  PubMed  Google Scholar 

  29. Ohlbaum P, Galperine RI, Demarquez JL, Vergnes P, Martin C (1987) Use of a long-acting somatostatin analogue (SMS 201-995) in controlling a significant ileal output in a 5-year-old child. J Pediatr Gastroenterol Nutr 6(3):466–470

    Article  CAS  PubMed  Google Scholar 

  30. Paran H, Neufeld D, Kaplan O, Klausner J, Freund U (1995) Octreotide for treatment of postoperative alimentary tract fistulas. World J Surg 19(3):430–433, discussion 433

    Article  CAS  PubMed  Google Scholar 

  31. Radetti G, Gentili L, Paganini C, Messner H (2000) Cholelithiasis in a newborn following treatment with the somatostatin analogue octreotide. Eur J Pediatr 159(7):550

    Article  CAS  PubMed  Google Scholar 

  32. Rahbour G, Siddiqui MR, Ullah MR, Gabe SM, Warusavitarne J, Vaizey CJ (2012) A meta-analysis of outcomes following use of somatostatin and its analogues for the management of enterocutaneous fistulas. Ann Surg 256(6):946–954

    Article  PubMed  Google Scholar 

  33. Reck-Burneo CA, Parekh A, Velcek FT (2008) Is octreotide a risk factor in necrotizing enterocolitis? J Pediatr Surg 43(6):1209–1210

    Article  PubMed  Google Scholar 

  34. Redfern JS, Fortuner WJ 2nd (1995) Octreotide-associated biliary tract dysfunction and gallstone formation: pathophysiology and management. Am J Gastroenterol 90(7):1042–1052

    CAS  PubMed  Google Scholar 

  35. Rushforth JA, Beck JM, McMahon M, Puntis JWL (1993) Resolution of pancreatic ascites with octreotide. Arch Dis Child 68:135–136

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  36. Stavrou GA, Fischer R, Kaczmarek S, Kirschstein M, Oldhafer KJ (2008) Non-surgical management of a ruptured posttraumatic pancreatic pseudocyst in a child. Adv Med Sci 53(2):331–334

    Article  CAS  PubMed  Google Scholar 

  37. Stevens P, Foulkes RE, Hartford-Beynon JS, Delicata RJ (2011) Systematic review and meta-analysis of the role of somatostatin and its analogues in the treatment of enterocutaneous fistula. Eur J Gastroenterol Hepatol 23(10):912–922

    Article  CAS  PubMed  Google Scholar 

  38. Tauber MT, Harris AG, Rochiccioli P (1994) Clinical use of the long acting somatostatin analogue octreotide in pediatrics. Eur J Pediatr 153(5):304–310

    Article  CAS  PubMed  Google Scholar 

  39. Uba FA, Uba SC, Ojo EO (2012) Management of postoperative enterocutaneous fistulae in children: a decade experience in a single centre. Afr J Paediatr Surg 9(1):40–6

    Article  PubMed  Google Scholar 

  40. Wallace AM, Newman K (1991) Successful closure of intestinal fistulae in an infant using the somatostatin analogue SMS 201-995. J Pediatr Surg 26(9):1097–1100

    Article  CAS  PubMed  Google Scholar 

  41. Wensil AM, Balasubramanian SA, Bell TL (2011) Resolution of a posttraumatic pancreatic pseudocyst with octreotide acetate in a pediatric patient. Pharmacotherapy 31(9):924

    Article  PubMed  Google Scholar 

Download references

Funding source

This work was performed without any specific support.

Authors’ contribution

Noela Carrera Guermeur: Dr. Carrera designed the study, drafted the initial manuscript, and approved the final manuscript as submitted.

Rosa M. Martín-Crespo Izquierdo, Hilda J. Ramírez Velandia, Ángel Pantoja Bajo: Dr. Martín-Crespo, Dr. Ramírez, and Dr. Pantoja treated the patient reported and provided the images presented, performed the extensive literature search in adult and child literature both from the medical and surgical points of view, reviewed and accepted the text we are submitting.

Rafael Luque-Mialdea: Dr. Luque-Mialdea coordinated and reviewed the entire process from design of the work to submission to the journal.

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Complejo Hospitalario de Toledo, Avenida de Barber, No 30, 45004, Toledo, Spain

    Noela Carrera-Guermeur, Rosa M. Martín-Crespo, Hilda J. Ramírez & Rafael Luque-Mialdea

  2. Division of Neonatology, Department of Pediatrics, Complejo Hospitalario de Toledo, Avenida de Barber, No 30, 45004, Toledo, Spain

    Ángel Pantoja

Authors
  1. Noela Carrera-Guermeur
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rosa M. Martín-Crespo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hilda J. Ramírez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ángel Pantoja
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rafael Luque-Mialdea
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Noela Carrera-Guermeur.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

The patient’s parents gave their informed consent prior to his inclusion in the study.

Additional information

Communicated by Patrick Van Reempts

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Carrera-Guermeur, N., Martín-Crespo, R.M., Ramírez, H.J. et al. Octreotide and enterocutaneous fistula closure in neonates and children. Eur J Pediatr 175, 305–312 (2016). https://doi.org/10.1007/s00431-016-2693-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-016-2693-y

Keywords

Search

Navigation