Nonsteroidal anti-inflammatory drugs: An unusual cause of multiple ileal perforations

Abstract

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. In this case report, we describe a rare case of pneumoperitoneum with peritonitis due to multiple ileal perforations with a history of high doses of diclofenac sodium usage. Case Report: A young adult male with recent history of high doses of Nonsteroidal antiinflammatory drugs (NSAIDs) presented in emergency department with acute onset pain in right iliac fossa with high grade fever and tachycardia for 12 hours. Abdomen was tender in the right iliac fossa with guarding. X-ray of chest showed free gas under the diaphragm. Exploratory laparotomy was done and showed multiple ileal perforations. Ressection and anastomosis of the affected segment was done, both ends brought as double barrel ileostomy which was reversed later on without any complication. Conclusion: High doses of Nonsteriodal anti-inflammatory drugs can cause multiple ileal erosions and perforation and should be considered in the the differential diagnosis, if other possibilities are excluded.