[Diagnostic imaging of NSAID ulcers]

Nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin cause frequently gastrointestinal injuries. In the acute phase of NSAIDs damage, endoscopic findings of gastroduodenal injuries are observed as acute gastroduodenal mucosal lesion (AGDML). Especially, non-aspirin NSAIDs cause sometimes hemorrhagic gastroduodenal ulcers. In the chronic phase of NSAIDs damage, multiple antral erosions and/or ulcers with oozing, and punched-out antral ulcers are characteristic findings. Recently, it was noted by capsule-endoscopy and double-balloon endoscopy that NSAIDs induce more frequent small intestine lesions. The characteristic findings of them are multiple erosions and/or ulcers in various forms. Circular ulcers of the small intestine and colon ulcers, colitis are induced by NSAIDs lower frequency comparing with upper GI tract injuries. In conclusion, characteristic images of gastrointestinal injuries induced by NSAIDs are multiple erosions and ulcers with bleeding without symptoms. It is most important asking about use of NSAIDs if we see such endoscopic images.