Kosin Med J.  2014 Dec;29(2):147-150. 10.7180/kmj.2014.29.2.147.

A Case of Ischemic Colitis Related with Usual Dosage of Ibuprofen in a Young Man

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea.

Abstract

Ischemic colitis is a medical condition in which inflammation and injury of the large intestine result from inadequate blood supply. Although uncommon in the general population, ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia. Other possible causes include medications such as NSAIDs(non-steroidal antiinflammatory drugs), oral contraceptives, diuretics and others. In recent years, many of NSAID use in young age can cause ischemic lesions, but it is not common. Here we report a case of ischemic colitis in a 31-year-old man who had no specific medical history except taking 200mg of ibuprofen three times a day for seven days. It suggests the importance of precise history taking, including medications usage such as NSAIDs and other risk factors.

Keyword

ischemic colitis; Ibuprofen; NSAID

MeSH Terms

Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal
Colitis, Ischemic*
Contraceptives, Oral
Diuretics
Humans
Ibuprofen*
Inflammation
Intestine, Large
Ischemia
Risk Factors
Anti-Inflammatory Agents, Non-Steroidal
Contraceptives, Oral
Diuretics
Ibuprofen

Figure

  • Fig 1. Abdominal comp䴸terized tomography showed the wall thickening of the colons, from ascending to transverse colon, and a small amᄋ䴸nt of the fluid in the right lower abdomen. The scans are otherwise 䴸nremarkable.

  • Fig 2. C㢌onoscopy showing hyperemic granular and easy friable m䴸cosa, with linear 䴸lcers running along the longit䴸dinal axis from ascending to transverse c㢌on.

  • Fig 3. C㢌onscopic biopsy showing loss of the s䴸rface epitheli䴸m, s䴸perficial m䴸cosal necrosis, and hemorrhagic foci in the lamina propria and lymhocyte cell infiltration.

  • Fig 4. Abdominal angiographic comp䴸terized tomography showing patent mesenteric vessels and no other abnormal findings

  • Fig 5. Colonoscopy performed at 7 days of admission showed several ᅵongit䴸dinaᅵ hyperemic m䴸cosa form ascending colon to transverse c㢌on, improving compared with the previo䴸s st䴸dy.


Reference

1.Higgins PD., Davis KJ., Laine L. Systematic review: the epidemiology of ischaemic colitis. Aliment Pharmacol Ther. 2004. 19:729–38.
2.Green BT., Tendler DA. Ischemic colitis: a clinical review. South Med J. 2005. 98:217–22.
Article
3.Gibson GR., Whitacre EB., Ricotti CA. Colitis induced by Nonsteroidal anti-inflammatory drugs. Report of and review of the literature. Arch Intern Med. 1992. 152:625–32.
4.Bjarnason I., Hayllar J., MacPherson AJ., Russell AS. Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans. Gastroenterology. 1993. 104:183–47.
Article
5.Carratu R., Parisi P., Agozzino A. Segmental ischaemic colitis associated with nonsteroidal antiinflammatory drugs. J Clin Gastroenterol. 1993. 16:31–4.
6.Appu S., Thompson G. Gangrenous ischemic colitis following non-steroidal anti inflmmatory drug overdose. ANZ J Surg. 2001. 71:694–5.
7.Vane JR. Inhibition of prostaglandin synthesis as a mechanism of action of aspirin - like drugs. Nat New Bial. 1971. 231:232–5.
8.Mahmud T., Rafi SS., Scott DL., Wrigglesworth JM., Bjarnason I. Nonsteroidal antiinflammatory drugs and uncoupling of mitochondrial oxidative phosphorylation. Arthritis Rheum. 1996. 39:1998–2003.
Article
9.Brune K., Schweitzer A., Eckert H. Parietal cells of the stomach trap salicylates during absorption. Biochem Pharmacol. 1977. 26:1735–40.
Article
10.Davies NM., Wallace JL. Nonsteroidal anti-inflammatory drug-induced gastrointestinal toxicity: New insights into an old problem. J Gastroenterol. 1997. 32:127–33.
Article
11.Appleyard CB., McCafferty DM., Tigley AW., Swain MG., Wallace JL. Tumor necrosis factor mediation of NSAID-induced gastric damage: role of leukocyte adherence. Am J Physiol. 1996. 270:G42–8.
Article
12.Aabakken L., Osnes M. Non-steroidal anti-inflammatory drug-induced disease in the distal ileum and large bowel. Scand J Gastroenterol Suppl. 1989. 163:48–55.
Article
13.Gargot D., Chaussade S., d'Alteroche L., Desbazeille F., Grand-jouan S., Louvel A, et al. Non-steroidal anti-inflammatory drug-induced colonic strictures: two cases and literature review. Am J Gastroenterology. 1995. 90:2035–8.
14.Gut A., Halter F., Ruchti C. Nonsteroidal antirheumatic drugs and acetylsalicylic acid: adverse affects distal to the duodenum. Schweiz Med Wochenschr. 1996. 126:616–25.
15.Bjarnason I., Hayllar J., MacPherson AJ., Russell AS. Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans. Gastroenterology. 1993. 104:1832–47.
Article
Full Text Links
  • KMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr