Endoscopy 2000; 32(7): 539-541
DOI: 10.1055/s-2000-3812
Case Report
Georg Thieme Verlag Stuttgart ·New York

Penetration by a Giant Gastric Ulcer Induced by a Nonsteroidal Anti-Inflammatory Drug

I. Shimizu 1 , T. Horie 2 , H. Inoue 2 , T. Oshima 2 , M. Fujimoto 2 , Y. Ozaki 2 , K. Yamamoto 2 , A. Iuchi 2 , S. Ito 1
  • 1 Second Dept. of Internal Medicine, School of Medicine, University of Tokushima, Tokushima, Japan
  • 2 Dept. of Internal Medicine, Miyoshi Prefectural Hospital, Tokushima, Japan
Further Information

Publication History

Publication Date:
31 December 2000 (online)

A patient presented with penetration by a giant gastric ulcer resulting from treatment with a nonsteroidal anti-inflammatory drug. A test for Helicobacter pylori proved negative. Treatment with a combination of an inhibitor of gastric acid secretion and prostaglandin substitution therapy with misoprostol resulted in closure of the perforation and cicatrization of the gastric ulcer without the need for laparotomy.

References

  • 1 Vane J R. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs.  Nature. 1971;  231 232-235
  • 2 Caruso I, Bianchi P G. Gastroscopic evaluation of anti-inflammatory agents.  Br Med J. 1980;  290 75-78
  • 3 The Committee on Safety of Medications. Non-steroidal anti-inflammatory drugs and serious gastrointestinal adverse reactions - 2.  Br Med J. 1986;  292 1190-1191
  • 4 Lanza F L. NSAIDs and the gastrointestinal tract.  Abdom Imaging. 1997;  22 1-4
  • 5 MacDonald T M, Morant S V, Robinson G C, et al. Association of upper gastrointestinal toxicity of non-steroidal anti-inflammatory drugs with continued exposure: cohort study.  Br Med J. 1997;  315 1333-1337
  • 6 Lanas A, Serrano P, Bajador E, et al. Evidence of aspirin use in both upper and lower gastrointestinal perforation.  Gastroenterology. 1997;  112 683-689
  • 7 Shiokawa Y, Nobenaga T, Saito T, et al. Epidemiological survey on association of upper gastrointestinal toxicity of non-steroidal anti-inflammatory drugs with continued exposure in Japan.  Rhyumachi (in Japanese). 1991;  31 96-111
  • 8 Graham D Y, Agrawal N M, Roth S H, et al. Duodenal and gastric ulcer prevention with misoprostol in arthritis patients taking NSAIDs.  Ann Intern Med. 1993;  119 257-262
  • 9 Koch M, Capurso L, Dezi A, et al. Prevention of NSAID-induced gastroduodenal mucosal injury: meta-analysis of clinical trials with misoprostol and H2-receptor antagonists.  Dig Dis Sci. 1995;  13 (Suppl 1) 62-74

I. Shimizu, M.D.

Second Dept. of Internal Medicine Tokushima University School of Medicine

Kuramoto-cho Tokushima 770-8503 Japan

Fax: Fax:+ 81-886-33-9235

Email: E-mail:shimizui@clin.med.tokushima-u.ac.jp

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