NSAIDs
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NSAIDs Pyloroduodenal obstruction: 10 case reports
Ten patients developed pyloroduodenal obstruction following long-term treatment with NSAIDs (aspirin, diclofenac, ibuprofen and nimesulide).
Patient characteristics Pt/sex/ age
Drug, tablet strength
Tablets taken per day
1/M/50 2/M/35
Aspirin 325mg Nimesulide 100mg Nimesulide 100mg, Aspirin 325mg Diclofenac 50mg Ibuprofen 400mg Nimesulide 100mg Ibuprofen 400mg Diclofenac 50mg Ibuprofen 400mg, Diclofenac 50mg Ibuprofen 400mg
1 3
3 20
duodenum duodenum
5a
9
pylorus
6
3
6
4
pylorus, duodenum duodenum
4
12
2
20
8
8
4a
12
6
7
3/M/40
4/F/19 5/F/51 6/M/40 7/M/85 8/M/40 9/M/40
10/M/52 a
Duration of treatment (y)
Site of obstruction
pylorus, duodenum duodenum pylorus, duodenum pylorus, duodenum
duodenum
dosage not clearly stated
Eight males and two females, aged between 19-85 years, presented with vomiting, alone or associated with abdominal pain or weight loss for a mean duration of 9 months. All patients had been receiving NSAIDs for a median of 8 years [indication not stated; duration of treatment to reaction onset not clearly stated]. Diagnostic endoscopy revealed strictures in the duodenum and/or pylorus. Ulceration at the rim of the strictures were noted in 3 patients. All patients underwent a mean of two endoscopic balloon dilatation procedures to achieve a luminal target diameter of 15mm, and required a mean of 5.3 dilatations to maintain luminal patency. Follow-up lasted for an average of 12 months. Nine patients were successfully treated. Patient 2 required a gastrojejunostomy because of failed endoscopic treatment and persistent symptoms. Author comment: "The predilection for [duodenal strictures] in our patients may be due to more frequent use of nonenteric-coated preparations on India." Noor MT, et al. NSAIDs-related pyloroduodenal obstruction and its endoscopic management. Diagnostic and Therapeutic Endoscopy 2011: No. 967957, 2011. 803062281 Available from: URL: http://dx.doi.org/10.1155/2011/967957 - India
0114-9954/10/1376-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 5 Nov 2011 No. 1376
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