Reactions 895 - 30 Mar 2002

★ SOctreotide

First report of intestinal perforation in an elderlypatient: case report

A 75-year-old woman with gastrointestinal symptomssecondary to scleroderma experienced a spontaneousintestinal perforation during treatment with octreotide.

The woman reported increased abdominal discomfort andbloating 5 days after starting treatment with SC octreotide 0.5mg/day. A CT scan revealed a substantial amount of free air inher abdominal cavity, and some dilation of her small and largebowels.

Octreotide was discontinued and the woman was treatedwith IV fluids and antibacterials, and underwent a period of ‘nilby mouth’. Her abdominal symptoms settled quickly. The siteof her intestinal perforation was never located.

Author comment: ‘It is possible that the intraluminalpressure increase associated with octreotide predisposed tointestinal perforation in this patient with myopathic intestinalpseudo-obstruction and a thin bowel wall due to scleroderma.’Malcolm A, et al. Intestinal perforation associated with octreotide therapy inscleroderma. American Journal of Gastroenterology 96: 3206-3208, Nov 2001 -Australia 800886769

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of intestinal perforationassociated with octreotide. The WHO Adverse Drug Reactionsdatabase contained 3 reports of intestinal perforation associatedwith octreotide.

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Reactions 30 Mar 2002 No. 8950114-9954/10/0895-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved