Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7484
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
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.
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.
For patients with a high-risk of VCME, octreotide should be cautiously admini
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.