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Treatment of postoperative enterocutaneous fistulas with octreotide in two neonates
R Karabulut1, C Karakuş, I Hirfanoğlu
1Department of Pediatric Surgery, Gazi University, Faculty of Medicine, Ankara, Turkey. karabulutr@yahoo.com
Insights
Octreotide effectively treated enterocutaneous fistula (EF) in two neonates, leading to spontaneous closure. This drug reduces gastrointestinal secretions and motility, aiding fistula healing in premature infants.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Clinical pharmacology
Background:
- Enterocutaneous fistula (EF) is a serious complication in neonates, often following necrotizing enterocolitis (NEC) or abdominal surgery.
- Current conservative management includes bowel rest, antibiotics, wound care, and medications to reduce gastrointestinal activity.
Observation:
- Octreotide, a drug that reduces gastrointestinal secretions and motility, was administered to two neonatal patients with EF.
- One patient was a premature neonate with NEC, and the other had meconium peritonitis.
Findings:
- Treatment with octreotide resulted in the successful spontaneous closure of the enterocutaneous fistula in both cases.
- Octreotide's mechanism of action, by decreasing secretions and gut motility, appears beneficial for fistula healing.
Implications:
- Octreotide represents a promising therapeutic option for managing enterocutaneous fistulas in neonates.
- Further research could explore octreotide's efficacy in a larger cohort of neonates with EF.
Abstract:
Enterocutaneous fistula (EF) in newborns and prematures is a well-recognized complication after necrotizing enterocolitis and other abdominal surgical procedures. Conservative management consists of bowel rest, antibiotics, wound care, and the administration of drugs that either reduce gastrointestinal motility or secretions. Octreotide decreases gastrointestinal secretions, inhibits or blocks the effects of gastrointestinal hormones, diminishes gut motility and thus reduces the flow through the fistula. We used octreotide and were able to report successful spontaneous closure of a fistula in our 2 neonatal patients, one a premature neonate with necrotizing enterocolitis (NEC) and the other with meconium peritonitis.
