Somatostatin for Bleeding Oesophagitis or Ulceration After Sclerotherapy for Oesophageal Varices

Jenkins, S.A., Shields, R., Jaser, N., Ellenbogen, S., Makin, C., Naylor, E., Newstead, M., Baxter, J.N. (1991) The Management of gastrointestinal haemorrhage by somatostatin after apparently successful endoscopic injection sclerotherapy for bleeding oesophageal varices. Journal of Hepatology; 12: 296-301. Twenty-two patients who experienced a severe haemorrhage from either oesophagitis (n 8) or ulcers (n 14) following injection sclerotherapy of their oesophageal varices were treated with intravenous administration of somatostatin (250 g/h). Somatostatin was effective in controlling haemorrhage and preventing rebleeding in all eight patients bleeding from oesophagitis and in 12 of the 14 patients bleeding from oesophageal ulcers. In two patients with ulcers, haemorrhage persisted despite two periods of concominant balloon tamponade and somatostatin infusion and bleeding was eventually controlled by repeated hourly bolus injections of the hormone for 24 h superimposed on the continuous infusion. The results of this study suggest that somatostatin is an effective and safe treatment for the control of bleeding from either oesophagitis or ulcers following injection sclerotherapy of oesophageal varices. HPB INTERNATIONAL 285