Treatment of duodenocutaneous fistula with somatostatin analog in a child with dermatomyositis.

A 6-year-old girl with juvenile dermatomyositis complicated by five duodenal perforations is described. The treatment consisted of suture closure of the perforations, reinforcement of the suture line with an omental graft, and adequate drainage of the closure site. The use of a somatostatin analog was successful in promptly arresting a leak from the duodenal perforations that had persisted for 3 months after the operation despite prolonged bowel rest and total parenteral nutrition. On follow-up observation 2 months later, the patient had no abdominal complaints and was tolerating oral intake without problems.