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Multiple indomethacin-induced colonic perforations in an adolescent
1Department of Paediatric Surgery, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899. amos.loh.hp@kkh.com.sg
Singapore Medical Journal
|May 10, 2011
Summary
A rare case of multiple colonic perforations in an adolescent linked to oral indomethacin highlights the risks of non-steroidal anti-inflammatory drugs (NSAIDs) in young patients. This study reviews NSAID-related bowel injury and potential causes for rapid progression.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Pharmacology
Background:
- Colonic perforation is a rare but serious condition in children, often posing diagnostic and management difficulties.
- Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used but can cause gastrointestinal complications.
Observation:
- An adolescent patient experienced multiple colonic perforations after a brief course of oral indomethacin.
- This represents the youngest documented case of large bowel injury attributed to enteral NSAID use.
Findings:
- The patient required an emergency hemicolectomy due to the severe colonic perforations.
- The clinical course was unusually rapid, suggesting potentiation of NSAID toxicity.
Implications:
- This case underscores the potential for severe NSAID-induced enteropathy in pediatric patients.
- Further research into the mechanisms of NSAID toxicity in the pediatric bowel is warranted to prevent such adverse events.
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