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American Journal of Hospice and Palliative Medicine®
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Malignant Irreversible Intestinal Obstruction: The Powerful Association of Octreotide to Corticosteroids, Antiemetics, and Analgesics

Catherine Weber, MD

Department of Rehabilitation and Geriatrics, Service of Palliative Medicine, University Hospitals of Geneva, Collonge-Bellerive, Switzerland

Gilbert B. Zulian, MD

Department of Rehabilitation and Geriatrics, Service of Palliative Medicine, University Hospitals of Geneva, Collonge-Bellerive, Switzerland, gilbert.zulian{at}hcuge.ch

In the case of malignant intestinal obstruction, surgery often carries important mortality and morbidity risks, and feasibility is neither realistic nor reasonable. A total of 4 clinical cases of intestinal obstruction caused by advanced gastrointestinal cancers in their terminal phase are described. The association of analgesics, corticosteroids, antiemetics, and octreotide was effective to relieve symptoms of intestinal obstruction for the remaining lifetime. The insertion of a nasogastric tube was avoided in 3 of 4 cases. Death occurred 51, 56, and 64 days after clinical and radiological diagnosis of irreversible intestinal obstruction. This combination of drugs appears very powerful and well tolerated. The relatively long survival that was observed should encourage future studies of longer half-life somatostatin analogues with no need of continuous infusion or multiple daily injections.

Key Words: intestinal obstruction • octreotide • symptoms

This version was published on April 1, 2009

American Journal of Hospice and Palliative Medicine®, Vol. 26, No. 2, 84-88 (2009)
DOI: 10.1177/1049909108327967
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