Abstract

MENESES, Daniela Gois; PINTO, Elizete Aparecida L. C  and  TOMMASO, Adriana Maria A. de. Octreotide for acute gastrointestinal bleeding secondary to portal hypertension in pediatric patients: experience of a tertiary center. Rev. paul. pediatr. [online]. 2011, vol.29, n.4, pp. 606-611. ISSN 0103-0582.  http://dx.doi.org/10.1590/S0103-05822011000400021.

OBJECTIVE: To describe clinical data of children and adolescents with portal hypertension, during with and without liver cirrhosis, treated with octreotide during episodes of acute upper gastrointestinal bleeding. METHODS: Retrospective and descriptive study of 26 episodes of gastrointestinal bleeding in 17 patients (mean age: 8.6 years; range: seven months to 18.9 years) assisted at a tertiary university hospital from 1996 to 2006. Portal hypertension diagnosis was based on ultrasonography. Liver cirrhosis was confirmed by histology and hepatic function was classified according the Child-Pugh score. RESULTS: Portal hypertension etiology was extra-hepatic portal vein obstruction in 11/17 (65%) patients and cirrhosis in 6/17 (35%). Bleeding was controlled in 14/17 (82%) patients. Octreotide infusion requirement was similar in cirrhotic and non-cirrhotic patients, but the decline in hemoglobin levels and the requirement of blood transfusions were greater but not significant in cirrhotic patients. The patients' responses were similar regardless of drug infusion strategy. Whether it included a loading dose or not. Treatment failure was observed mainly among cirrhotic patients (33%). Hyperglycemia was the only side effect detected during octreotide infusion. CONCLUSIONS: Octreotide administration in children and adolescents with digestive bleeding due to portal hypertension was safe and effective in order to control the acute episode of bleeding, regardless of the etiology of portal hypertension and infusion strategy.

Keywords : octreotide; gastrointestinal bleeding; hypertension, portal; child; adolescent.