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

Hidetaka Shigeta, Kazuhiro Hiramatsu and Yasunobu Mizukami

Department of Surgery, Enshu Hospital

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.

Key words
somatostatin analogue, proton pump inhibitor, refractory enterocutaneous fistula

Reprint requests
Hidetaka Shigeta Department of Surgery, Enshu Hospital
1-1-1 Chuou-ku, Hamamatsu, 430-0929 JAPAN

Accepted
February 20, 2008

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