Long-acting Release Octreotide for Pediatric Upper Gastrointestinal Bleeding

Abstract

Introduction: Upper gastrointestinal bleeding (UGIB) secondary to portal hypertension (PHT), without endoscopic or surgical treatment options due to an ectopic or unidentified bleeding site or the patient’s anatomic characteristics, is challenging in pediatric hepatology. The usual treatment in these cases includes intravenous Octreotide. Recently, the availability of long-acting release Octreotide (OCT-LAR) for monthly intramuscular administration has become an interesting therapeutic alternative.

Objective: To report the case of an infant with UGIB due to PHT who was successfully treated with OCT-LAR.

Clinical Case: Eight-month-old patient with repeated episodes of UGIB due to extrahepatic portal vein malformation, requiring blood transfusions, and intravenous octreotide infusions. As neither endoscopic nor surgical treatment were feasible, we decided to start IM OCTLAR monthly. After ten months of treatment, the patient did not present bleeding episodes. No medication-related events were observed.

Conclusion: We consider that this report could help in the management of similar pediatric patients with UGIB due to PHT without conventional therapeutic possibilities.