Small Bowel Bleeding and Perforation of NSAID-Associated Small Bowel Ulceration.
- Author:
Nam Joon YI
1
;
Young Woo KIM
;
Han Chu LEE
;
Ho Seong HAN
Author Information
1. Department of Surgery, College of Medicine, Ewha Womans University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
NSAID;
Small bowel ulceration;
Surgical complications
- MeSH:
Abdomen, Acute;
Diagnosis, Differential;
Female;
Hemorrhage*;
Humans;
Inflammatory Bowel Diseases;
Malnutrition;
Medical Records;
Peptic Ulcer;
Retrospective Studies;
Ulcer*
- From:Journal of the Korean Surgical Society
2000;59(6):821-827
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAID) are well known to be associated with gastroduodenal ulcers. Also, small bowel ulceration sometimes develops. The authors reviewed their experiences to emphasize clinical importance of this disease entity. METHODS: A retrospective study was performed for patients who had undergone surgical intervention for lower gastrointestinal bleeding, small bowel perforation, or obstruction at Ewha Womans University Mok-Dong Hospital during a 5-year period. The cases related to acute trauma, postoperative obstruction, malignant ulceration, specific inflammatory bowel disease and other definite gastrointestinal lesions were excluded. The medical records were reviewed and the patients were interviewed. RESULTS: Out of total 110 cases, 4 patients had histories of NSAID use. They showed emergent presentations of acute abdomen, who were in debilitated or malnutrition states with underlying disease, without protective management for NSAID-use. They had all undergone surgical interventions because of small bowel ulcerations and its complications. CONCLUSION: NSAID induced small bowel ulcers should be a differential diagnosis of an acute abdomen or lower gastrointestinal bleeding of uncertain origin, especially for older age, and for patient with debilitating disease. Misuse or overuse of NSAID should be avoided to prevent ulcer complications, especially in high-risk patients.
