Two Cases of Refractory Enterocutaneous Fistula which were Treated Effectively with Somatosatin Analogue and Proton-Pump Inhibitor

• Published in: The Japanese Journal of Gastroenterological Surgery Vol. 41; no. 9; pp. 1723 - 1728
• Main Authors: Shigeta, Hidetaka, Hiramatsu, Kazuhiro, Mizukami, Yasunobu
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2008
• Subjects: proton pump inhibitor; refractory enterocutaneous fistula; somatostatin analogue
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.41.1723

We reported two cases of refractory enterocutaneous fistula treated with somatostatin analogue (SMS) and proton-pump inhibitor (PPI). Case1: An 87-year-old woman reporting upper abdominal pain diagnosed with diffuse peritonitis due to a perforated duodenal ulcer underwent omental patch repair. On postoperative day (POD) 2, intestinal fluid was discharged from the omental patch drain, resulting in a refractory duodenocutaneous fistula. SMS was injected with PPI and the discharge rapidly decreased. On day 19 after SMS injection, the fistula had closed. Case 2: A 65-year-old man undrgoing hemicolectomy for ascending colon cancer was found on POD 10 to have changed drain content and anastomotic leakage. Intestinal fluid discharged from the median surgical incision resulted in a refractory ileocolonic anastomocutaneous fistula. SMS was injected with PPI and the discharge rapidly decreased. On day 11 after SMS injection, the fistula had closed.