SUCCESSFUL MANAGEMENT WITH OCTREOTIDE OF A CHILD WITH L-ASPARAGINASE INDUCED HEMORRHAGIC-PANCREATITIS

Background. Octreotide is a synthetic somatostatin analogue which has been suggested for use in the management of acute pancreatitis. While studies have looked at octreotide use in the setting of pancreatitis d ue to chronic al cohol use or trauma, little is known of its role in m anagement of drug induced acute pancreatitis tis, particularly in the pediatric setting. Patients and Methods. We present a case of a 51/2-y ear-old white female who developed severe, necrotizing, hemorrhagic pa ncreatitis with pseudocyst formation secondary to L-asparaginase use a s a part of her therapy for acute lymphoblastic leukemia (ALL). She wa s managed initially with intravenous fluids, bowel rest, nasogastric s uctioning, parenteral narcotices, and broad spectrum antibiotics. In-a ddition, within 12 hours of admission to The Children's Hospital (TCH) in Denver, Colorado, she began therapy with octreotide (5 micrograms/ kg/day IV divided b.i.d.). With this management, her pseudocyst decomp ressed without need for surgical intervention, her pancreatitis fully resolved, and she recovered full pancreatic function without any long- term sequelae. Conclusion. Use of octreotide may have served a role in limiting the severity of the disease process in this case. Further st udies need to be done to verify its usefulness in this setting. (C) 19 98 Wiley-Liss, Inc.