Multiple ileal perforations due to regular diclofenac sodium injections: a case report

BMC Research Notes

Ho Sung Park¹  Soo Teik Lee⁴  Seok Lee³  Sang Wook Kim⁴  Won Seok Park² 

[1] Departments of Pathology, Chonbuk National University College of Medicine, Jeonju, Republic of Korea;Division of Gastroenterology and Hepatology, Departments of Internal Medicine, Daejon St. Mary’s Hospital, The Catholic University of Korea, Daejon, Republic of Korea;Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Chungcheongbuk-do, Republic of Korea;Departments of Internal Medicine and Research Institute for Medical Science, Chonbuk National University College of Medicine, Geumam 2-dong, Deokjin-gu, Jeonju, 561-712, Republic of Korea

关键词: Non-steroidal anti-inflammatory agents;    Intestinal perforation;    Ileum;    Diclofenac sodium;   

Others  :  1143025
DOI  :  10.1186/1756-0500-6-129

 received in 2012-10-31, accepted in 2013-03-18,  发布年份 2013

【 摘 要 】

Background

Although the adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) on the upper gastrointestinal tract have been well characterized, those specific to the lower gastrointestinal tract are less clear, as only a limited number of articles and case reports exist in the literature.

Case presentation

We describe a case of a 69-year-old woman who presented to the emergency department due to sudden onset abdominal distension and pain. Notably, she reported using intramuscular diclofenac sodium twice daily for 14 days after knee joint replacement surgery. The patient denied any other coexisting diseases. As a subsequent X-ray and computed tomography (CT) scan showed free air in the abdomen, an exploratory laparotomy was performed, revealing four free perforations in the terminal ileum. Findings on microscopic analysis were non-specific.

Conclusion

We report a unique case of multiple ileal perforations due to regular diclofenac sodium injections and contend that ileal perforation can be considered as a source for pneumoperitoneum with concomitant peritonitis in patients with a history of NSAID use if other possibilities are excluded.

【 授权许可】

   
2013 Park et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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