Octreotide Therapy for Control of Acute Gastrointestinal Bleeding in Children

Abstract

A high rate of bleeding control was achieved with octreotide during acute gastrointestinal bleeding in children with portal hypertension. However, controlled studies are needed for more definitive description of its clinical effects. The role of octreotide is less clear in gastrointestinal bleeding unrelated to portal hypertension.

Safety of octreotide in hospitalized infants

“…Although octreotide is not labeled for use in children, case reports, case series, and cohort studies document the use of octreotide in children for several indications, including pancreatitis, chylothorax, and gastrointestinal bleeding [10–19]. In infants, the most common indication is treatment of congenital chylothorax, chylothorax secondary to thoracic surgery, congenital hyperinsulinism, and gastrointestinal bleeding [12–14].…”

Long-time octreotide in an adolescent with severe haemorrhagic gastrointestinal vascular malformation

“…No larger series but numerous case reports have been published so far 17 18. In paediatric liver disease with portal hypertension leading to acute haemorrhage, however, octreotide treatment was shown to be safe and effective 8 19. In infants, adrenal suppression and growth retardation were described, but followed by catch-up growth 8…”

Successful Control of Massive Gastrointestinal Bleeding Following Umbilical Cord Blood Transplantation (Ucbt) by Use of Recombinant Activated Factor Vii (Rfviia) and Octreotide Infusion

“…Eroglu and colleagues have reported a response rate of 50% to octreotide in gastrointestinal bleeding in patients without portal hypertension. However, effectiveness was particularly true for patients where the bleeding source was a discrete ulcer or a procedure site [9]. Octreotide has been shown to reduce splanchnic circulation as one of the suggested mechanism to treat GI bleed.…”

“…Gastrointestinal bleeding was the leading cause of hemorrhage (46.9%), followed by hemorrhagic cystitis (31.8%) and diffuse alveolar hemorrhage (13.3%).Response in terms of cessation or significant reduction of bleeding was observed in the majority of patients (69/ 113, 61.1%) [8]. Eroglu has reported a response rate of 50% to octreotide in gastrointestinal bleeding in patients without portal hypertension [9]. We present a 10 month-old female child, who had three episodes of life threatening lower GI bleeding post unrelated UCBT controlled successfully each time by use of rFVIIa and octreotide infusion and review of literature.…”