Omeprazole
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Necrotising pancreatitis: case report A 29-year-old man developed necrotising pancreatitis during treatment with omeprazole for gastritis. The man, who had a history of smoking 6–7 cigarettes/day and gastritis, presented to the hospital with acute-onset epigastric pain and vomiting. The abdominal pain began 3 hours after having lunch along with emesis for multiple times. Abdominal examination revealed epigastric tenderness. Laboratory tests showed elevated lipase level. He had been receiving omeprazole 20 mg/day intermittently [route not stated] and the most recent dose was taken on the night before the day of presentation. In the emergency department, an ultrasound of the abdomen showed a mildly dilated common bile duct. CT abdomen showed swelling of the distal pancreas and peripancreatic fluid without necrosis or abscess. He was admitted. The man was treated with unspecified analgesics and IV fluid for acute pancreatitis. On the very next day, a magnetic resonance cholangiopancreatography showed extensive oedema of the pancreas with a common bile duct. After 2 days of admission, he developed leukocytosis, tachypnoea and tachycardia, for which he required ICU admission. Repeat CT abdomen showed massive necrosis of pancreas up to 50% involving the proximal tail, neck and body along with fluid collection. A necrotising pancreatitis was considered [duration of treatment to reaction onset not stated]. He then began to have febrile episodes and was started on meropenem. Further, interventional radiology was consulted and the drainage showed brown fluid. Therefore, a catheter was placed for drainage of fluid. The fluid cultures showed no growth and the antibiotics were stopped after 4 days of initiation. His abdominal pain improved gradually and tube feeding was started initially and later oral diet. On 15th day of admission, he was discharged. His acute pancreatitis was complicated by a pseudocyst formation, which was diagnosed after 14 weeks of initial presentation when he presented with abdominal pain. Kathi P, et al. Omeprazole-associated necrotizing pancreatitis. American Journal of Therapeutics 27: E411-E412, No. 4, 2020. Available from: URL: http://doi.org/10.1097/ 803518227 MJT.0000000000000999
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Reactions 28 Nov 2020 No. 1832
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