TRAUMATIC PANCREATIC FISTULA IN CHILDREN - EARLY MANAGEMENT WITH A SOMATOSTATIN ANALOG AND DRAINAGE

The management of a high-output pancreatic fistula is often difficult, and can be even more challenging in the pediatric patient. Octreotide acetate (OA) (Sandos-tatin, Sandoz, East Hanover, NJ) has served To f acilitate the treatment of this difficult problem, but experience has been limited to adults. Somatostatin is a hormone that decreases the p roduction of pancreatic exocrine and endocrine secretions, The use of the long-acting somatostatin analogue, OA, has reduced pancreatic fist ula output and facilitated resolution of pancreatic fistulae in adults . This report summarizes the IV use of OA and external drainage in the complete resolution of high-output traumatic pancreatic fistulae in t hree pediatric patients. The treatment was well tolerated without side effects, acid resulted in a dramatic decrease in the amount of fistul a drainage within the first 24 to 48 h. OA can be safely administered IV (5-10 mu g/kg per day) and is valuable in the management of traumat ic pancreatic fistula in children.