J Korean Surg Soc.
2000 Dec;59(6):821-827.
Small Bowel Bleeding and Perforation of NSAID-Associated Small Bowel Ulceration
- Affiliations
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- 1Department of Surgery, College of Medicine, Ewha Womans University, Seoul, Korea.
- 2Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
Abstract
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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.