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Case Report
 
Nonsteroidal anti-inflammatory drugs: An unusual cause of multiple ileal perforations
Mohamed Ali Sheredi1, Zakaur Rab Siddiqui2
1Consultant General Surgeon, Arrayan Hospital, Dr Sulaiman Alhabib Medical Group, Riyadh, Saudi Arabia.
2Senior Specialist General Surgeon, Arrayan Hospital, Dr Sulaiman Alhabib Medical Group, Riyadh, Saudi Arabia.

doi:10.5348/ijcri-201596-CR-10557

Address correspondence to:
Dr. Zakaur Rab Siddiqui
Frcs, FCPS, Senior Specialist General Surgeon
Arrayan Hospital, Dr Sulaiman Alhabib Medical Group
Po Box 100266, Riyadh
Saudi Arabia

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How to cite this article
Sheredi MA, Siddiqui ZR. Nonsteroidal anti-inflammatory drugs. Int J Case Rep Images 2015;56(9):587–590.


Abstract
Introduction: 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 anti-inflammatory 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.

Keywords: Diclofenac sodium, Ileum, Intestinal perforation, Nonsteroidal anti-inflammatory drugs (NSAIDs)


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Author Contributions
Mohamed Ali Sheredi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Zakaur Rab Siddiqui – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Mohamed Ali Sheredi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.