Octreotide-induced acute life-threatening gallstones after vicarious contrast medium excretion: A case report

World J Clin Cases. 2021 Sep 6;9(25):7484-7489. doi: 10.12998/wjcc.v9.i25.7484.

Abstract

Background: Octreotide is widely used for the treatment of acromegaly, neuroendocrine tumors, and secretory diarrhea. However, long-term octreotide treatment can increase the incidence of gallstones. Vicarious contrast medium excretion (VCME) through the hepatobiliary system is well known. However, few studies have reported octreotide-induced acute gallstones following VCME.

Case summary: A 69-year-old man presented with left lower back pain and hematuria caused by a fall. The patient had a history of polycystic kidney disease. VCME occurred following renal artery embolization for a ruptured polycystic kidney. After 5 d of treatment with octreotide, the patient developed acute gallstones and intrahepatic cholestasis which further induced pancreatitis and cholangitis. He was discharged after hemodialysis, antibiotics, and supportive treatments.

Conclusion: For patients with a high-risk of VCME, octreotide should be cautiously administered and carefully monitored.

Keywords: Case report; Contrast medium; Gallstones; Octreotide.

Publication types

  • Case Reports