Multiple indomethacin-induced colonic perforations in an adolescent
Loh, A.H.P.; Ong, L.Y.; Liew, W.K.; Arkachaisri, T.; Lee, V.K.M.; Narasimhan, K.L.; Jacobsen, A.S.
Singapore Medical Journal 52(4): e82-e84
2011
ISSN/ISBN: 0037-5675 PMID: 21552780 Document Number: 648706
Colonic perforation is an uncommon cause of acute abdomen in paediatric patients, and can present a diagnostic enigma as well as management challenge to the paediatric surgeon. An adolescent developed multiple colonic perforations following a short course of oral indomethacin, requiring emergency hemicolectomy. This is the youngest known case of enteral non-steroidal anti-inflammatory drug (NSAID)-mediated large bowel injury. We review current evidence on NSAID-related enteropathy, and postulate potentiating mechanisms that may have accounted for the unusually rapid clinical course of our patient.