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Ristilþrengsli af völdum bólgueyðandi lyfja

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Authors
Hjörtur Fr Hjartarson
Nick Cariglia
Jóhannes Björnsson
Issue Date
2004-02-01

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Other Titles
NSAIDs-induced colopathy with diaphragm-like strictures. Case report
Citation
Læknablaðið 2004, 90(2):133-5
Abstract
A sixty-eight-year old male with osteoarthritis was admitted for elective hip replacement. Routine preoperative tests found the patient to be anemic and the operation was postponed. Colonoscopy revealed diaphragm-like strictures and ulcerations in the right colon. A right hemicolectomy was performed. It is believed that the lesions were due to the use of non-steroidal anti-inflammatory drugs (NSAIDs), as the patient had been taking diclofenac for the preceding eighteen months due to hip pain. At the time of this diagnosis, apparoximately thirty cases of colopathy with diaphragm-like strictures due to NSAID use had been reported worldwide. It is likely that with increasing use of slow-release and enterocoated preparations of NSAIDs, the number of similar cases will increase.
Sjúklingurinn er 68 ára gamall karlmaður með slitgigt sem lagður var inn á bæklunardeild Fjórðungssjúkrahússins á Akureyri (FSA) til gerviliðsaðgerðar á mjöðm. Fyrir aðgerð fannst járnskortsblóðleysi. Aðgerð var frestað á meðan skýringa blóðleysis var leitað. Frekari rannsóknir leiddu í ljós sáramyndanir í ristli með himnulíkum þrengingum. Voru hluti ristils og dausgarnar fjarlægðir með skurðaðgerð. Meinafræðirannsókn leiddi í ljós ristilþrengsli af því tagi sem lýst hefur verið eftir töku bólgueyðandi lyfja (NSAIDs). Sjúklingur hafði tekið díklófenak í um það bil eitt og hálft ár fyrir komu vegna verkja frá mjöðmum. Áður hefur verið lýst um það bil þrjátíu tilfellum sárasjúkdóms í ristli með hringlaga þrengingum af völdum bólgueyðandi lyfja. Í ljósi þess að notkun bólgueyðandi lyfja, sem ná hámarksþéttni í sermi á löngum tíma eða frásogast í fjarhlutum meltingarvegs eykst, má búast við að tilfellum sem þessum fjölgi á næstu árum.
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http://www.laeknabladid.is
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Icelandic Journal Articles (Peer Reviewed)

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