Therapeutic applications of octreotide in pediatric patients

We report our experience with the use of octreotide as primary or adjunctive therapy in children with various gastrointestinal disorders. A pharmacy database identified patients who received octreotide for gastrointestinal diseases. Indications for octreotide use, dosing, effectiveness, and adverse events were evaluated by chart review. A total of 21 patients [12 males], aged 1 month to 13 years, were evaluated. Eleven received octreotide for massive gastrointestinal bleeding caused by portal hypertension-induced lesions [n=7], typhlitis [1], Meckel's diverticulum [1], and indefinite source [2]. Blood transfusion requirements were reduced from 23 +/- 9 mL/kg [mean +/- SD] to 8 +/- 15 mL/kg [P<0.01]. Four patients with pancreatic pseudocyst and/or ascites received octreotide over 14.0 +/- 5.7 days in 2 patients. In 3 children, pancreatic pseudocyst resolved in 12 +/- 2 days and pancreatic ascites resolved in 7 days in 2. Three patients with chylothorax received octreotide for 14 +/- 7 days with complete resolution in each. Two infants with chronic diarrhea received octreotide over 11 +/- 4.2 months. Stool output decreased from 85 +/- 21 mL/kg/day to 28 +/- 18 mL/kg/day, 3 months after initiation of octreotide. The child with dumping syndrome responded to octreotide in a week. Adverse events developed in 4 patients: Q-T interval prolongation and ventricular fibrillation, hyperglycemia, growth hormone deficiency, and hypertension. Octreotide provides a valuable addition to the therapeutic armamentum of the pediatric gastroenterologist for a wide variety of disorders. Serious adverse events may occur and patients must be closely monitored

Pseudocisto de pâncreas: apresentaçäo incomum / Pancreatic pseudocyst: unusual presentation

Pseudocisto de pâncreas (PP) constitui complicaçäo relativamente comum dos pacientes com pancreatite aguda (9 a 56 por cento) e crônica (20 a 40 por cento). Relatamos caso de PP em paciente etilista cuja manifestaçäo se deu de forma atípica, atingindo espaço perirrenal esquerdo e musculatura paravertebral esquerda (músculo psoas), que regridiu com tratamento conservador. O pseudocisto pancreático com localizaçäo no músculo psoas, embora seja apresentaçäo rara, deve fazer parte do diagnóstico diferencial de dor lombar ou em quadril, especialmente em etilistas