Effects of octreotide pharmacotherapy in the treatment of complicated perforation of retroperitoneal duodenal ulcer

Duodenal ulcer is a defect in the mucosa. The main aetiological factors are <i>H. pylori</i> infection, nonsteroidal anti-inflammatory drugs, genetic factors, and nicotinism. Statistics confirm that perforation is a significant and potentially life-threatening ulcer complication in the Polish population. Octreotide is a somatostatin derivative that works by inhibiting the release of proteins of the gastrointestinal-pancreatic system. It is indicated in acromegaly, hormonally active gastrointestinal tumours, and oesophageal variceal bleeding. It can be used to reduce bile secretion and slow down gallbladder motility. The material for this review paper was a case of duodenal perforation in a woman aged 63 years. Octreotide used in the treatment of a difficult-to-heal anastomosis improved the patient’s local and general condition, and led to the closure of the anastomosis. Despite the significant number of circumstances leading to the patient’s life-threatening condition in the course of the perforation, there were also factors that positively influenced the treatment outcome. The most important of these was the use of octreotide to increase the chances of healing of the intestinal-intestinal anastomosis in the area of influence of digestive enzymes. The conclusions drawn from this case suggest that octreotide can be used in the treatment of non-healing, properly performed gastrointestinal anastomoses. More effective prophylaxis, early diagnosis of peptic ulcer disease, and increasing access to endoscopy are known to reduce the number of perforation cases. Importantly, there are cases of perforations that can be lifethreatening for the patient even in the course of anastomotic dissections of properly performed surgical procedures. Octreotide should be considered in the management of complicated and extreme perforations. This paper describes the possibility of using octreotide as a pharmacotherapy to increase the chances of gastrointestinal anastomosis healing in cases involving complicated duodenal perforations.