Han ZH, He ZM, Chen WH, Wang CY, Wang Q. Octreotide-induced acute life-threatening gallstones after vicarious contrast medium excretion: A case report. World J Clin Cases 2021; 9(25): 7484-7489 [PMID: 34616816 DOI: 10.12998/wjcc.v9.i25.7484]
Corresponding Author of This Article
Qi Wang, MD, Chief Doctor, Department of Interventional Radiology, The First People’s Hospital of Changzhou, No. 185 Juqian Street, Changzhou 213003, Jiangsu Province, China. czwangqi666@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2021; 9(25): 7484-7489 Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7484
Octreotide-induced acute life-threatening gallstones after vicarious contrast medium excretion: A case report
Zong-Hong Han, Zhong-Ming He, Wen-Hua Chen, Cao-Ye Wang, Qi Wang
Zong-Hong Han, Zhong-Ming He, Wen-Hua Chen, Cao-Ye Wang, Qi Wang, Department of Interventional Radiology, The First People’s Hospital of Changzhou, Changzhou 213003, Jiangsu Province, China
Author contributions: Han ZH and Wang CY conceived and designed the research; He ZM and Chen WH acquired data; Han ZH and Wang Q prepared and revised the manuscript; Chen WH provided helpful suggestions about the study; All authors issued final approval of the version for submission.
Supported bythe Changzhou Commission of Health, No. WZ201904.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qi Wang, MD, Chief Doctor, Department of Interventional Radiology, The First People’s Hospital of Changzhou, No. 185 Juqian Street, Changzhou 213003, Jiangsu Province, China. czwangqi666@sina.com
Received: January 16, 2021 Peer-review started: January 16, 2021 First decision: April 29, 2021 Revised: May 12, 2021 Accepted: July 16, 2021 Article in press: July 16, 2021 Published online: September 6, 2021 Processing time: 226 Days and 23.4 Hours
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.
Core Tip: Vicarious contrast medium (CM) excretion (VCME) through the hepatobiliary system is well known. Long-term octreotide treatment can increase the incidence of gallstones. In this case, acute gallstones may have been induced by octreotide after VCME through the hepatobiliary system. When the CM was excreted into the hepatobiliary system, which was retained for a long time and concentrated by octreotide, it might change the physicochemical properties of bile and decreased nucleation time, finally resulting in the formation of acute gallstones.
