A 73-year-old male patient was given intravenous infusion of ketorolac tromethamine injection 60 mg diluted in 0.9% sodium chloride injection 250 ml once daily for gouty arthritis. At about half of the third infusion, he developed dull pain in the stomach, but did not pay much attention to it. Then vomiting (with blood in the vomitus) and melena accompanied by epigastric discomfort occurred later. The symptoms were considered to be related to ketorolac tromethamine injection, the drug was stopped, and the patient′s condition was observed. But the above symptoms continued and worsened, and palpitation, dizziness, fatigue, hematemesis, fresh blood on defecation, syncope, etc. occurred. The patient′s blood pressure was 58/33 mmHg and hemoglobin was 92 g/L. Gastroscopy and pathological examination showed multiple ulcers in antrum and the angle of the stomach, chronic superficial and erosive gastritis, duodenal bulbar inflammation, and Helicobacter pylori (+). The patients were diagnosed with peptic ulcer and hemorrhagic shock. Norepinephrine, somatostatin, esomeprazole, and nutritional and supportive treatments were given, and 2 weeks later, the patient gradually recovered and the fecal occult blood was negative.

A 73-year-old male patient was given intravenous infusion of ketorolac tromethamine injection 60 mg diluted in 0.9% sodium chloride injection 250 ml once daily for gouty arthritis. At about half of the third infusion, he developed dull pain in the stomach, but did not pay much attention to it. Then vomiting (with blood in the vomitus) and melena accompanied by epigastric discomfort occurred later. The symptoms were considered to be related to ketorolac tromethamine injection, the drug was stopped, and the patient′s condition was observed. But the above symptoms continued and worsened, and palpitation, dizziness, fatigue, hematemesis, fresh blood on defecation, syncope, etc. occurred. The patient′s blood pressure was 58/33 mmHg and hemoglobin was 92 g/L. Gastroscopy and pathological examination showed multiple ulcers in antrum and the angle of the stomach, chronic superficial and erosive gastritis, duodenal bulbar inflammation, and Helicobacter pylori (+). The patients were diagnosed with peptic ulcer and hemorrhagic shock. Norepinephrine, somatostatin, esomeprazole, and nutritional and supportive treatments were given, and 2 weeks later, the patient gradually recovered and the fecal occult blood was negative.