Management of severe acute pancreatitis with a somatostatin analog in a patient undergoing surgery for dissecting thoracic aneurysm: Report of a case

A patient who was admitted to our hospital to undergo surgery for a dissect ing thoracic aneurysm suffered preoperatively from severe acute pancreatiti s with pancreatic pseudocysts. Computerized tomography (CT) demonstrated th e presence of new fluid collection around the cyst with the absence of panc reatic necrosis. He was given a somatostatin analog (sandostatin), which wa s effective in decreasing the abdominal symptoms, leukocyte counts, and the serum C-reactive/protein level. A CT scan revealed that the pancreatic pse udocyst and peripancreatic fluid collection had disappeared. Although somat ostatin has been reported to be ineffective for acute pancreatitis with nec rosis, pancreatitis without necrosis may regress after treatment with sando statin. This is probably due to its suppressive effect on the exocrine func tion, thus resulting in a decrease of pancreatic juice infiltration.