A case with postoperative cutaneointestinal fistula responding to somatostatin analog, with a special ref erence to serum level of gastrointestinal ho
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- るるみ ちゅうか
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1 A case with postoperative cutaneointestinal fistula responding to somatostatin analog, with a special ref erence to serum level of gastrointestinal hormones. Hiroshi KATAMURA1), Shigeo OHKI, Akira SUGITA, Shinichi ISHIHARA, Masayoshi YAMAMOTO2) and Mitsugi SUGIYAMA3) 1) Department of Surgery, National Hospital of Ito Spa, 2) Second Department of Surgery, Yokohama City University, School of Medicine, 3) Critical and Emergency Center, Yokohama City University, School of Medicine
2 Figure 1. Clinical course. Serial change of daily discharge from fistula orifice (?? ) and nasogas tric tube (solid line). Indicated are the period of total parenteral nutrition (TPN) and somatostatin analog (SMS) administration. Figure 2. a : Fistulagraphy using decompression tube showed the subcu taneous cavity (arrow) and the fistula originating from jejunal anastomosis. b : Fistula disappeared with one week treatment of somatostatin analog.
3 Table 1. Nutritional indeces before, during and after the administration of somatostatin analog Table 2. Volume and composition of intestinal output via an external fistula before and during treatment with somatostatin analog
4 Table 3. Serum levels of gut hormones before, during and after treatment with somatostatin analog Figure 3. Intragastric ph were monitored before and during SMS adminis tration. SMS : Sandostatin(R) 50ƒÊg s. c.
5 1) Klein E, Shnebaum S, Ben-Ari G, et al : Effects of total parenteral nutrition on exocrine pancre atic secretion. Am J Gastroenterol 1983, 78: ) Debas HT : Somatostatin : Physiologic and clini cal potential. Viewpoints on Digestive Diseases 1988, 20 : ) Heij HA, Bruining HA, Verschoor L : A Com parison of the effect of two somatostatin ana logues in a patient with an external pancreatic fistula. Pancreas 1986, 1 : ) Nubiola-Calonge P, Badia JM, Sancho J, et al : Blind evaluation of the effect of octreotide (SMS ), a somatostatin analogue, on small-bowel fistula output. Lancet 1987, ) Prinz RA, Pickleman J, Hoffmann JP, et al : Treatment of pancreatic cutaneous fistula with a somatostatin analogue. Am J Surg 1988, 155 : ) DeBois MHW, Bosman CHR, DeGraaf P, et al: Closure of a high output external pancreatic fis tula by SMS , a long-acting analogue of somatostatin. Neth J Med 1988, 32: ) Yamada T : Local regulatory actions of gastroin testinal peptides. In :Johnson LIZ, ed. Physiolo gy of the Gastrointestinal Tract, 2nd Ed, Raven Press, New York, 1987, 131 8) Hanssen LE, Hanssen KF, Myren U : Inhibition of secretin release and pancreatic bicarbonate secretion by somatostatin infusion in man. Scand J Gastroenterol 1980, 58 : ) Peeters TL, Janssens J, Vantrappen GR : So matostatin and the interdigestive migrating mo tor complex in man. Regul Pept 1983, 5: ) Krejs GJ, Orci L, Conlon JM, et al : Somato statinoma syndrome : Biochemical, morphologic and clinical features. N Engl J Med 1979, 301 : ) Koerker DJ, Harker LA, Goodner GJ : Effect of somatostatin on hemostasis in baboons. N Engl J Med 1975, 293 :
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