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Repeated bowel perforations with Ibuprofen lysine: a case report
Gregory J Peitz1, Eric B Hoie, Shannon Hoy
1Creighton University Medical Center.
Summary
Ibuprofen lysine treats patent ductus arteriosus in neonates. A rare case shows this drug may cause isolated bowel perforations in premature infants, a risk not previously reported.
Area of Science:
- Neonatal medicine
- Pharmacology
- Gastrointestinal surgery
Background:
- Non-steroidal anti-inflammatory drugs (NSAIDs) are standard treatments for patent ductus arteriosus in neonates.
- Ibuprofen lysine, a parenteral NSAID, is approved for neonates unresponsive to other medical treatments.
- While NSAIDs share side effects, spontaneous bowel perforation is not commonly associated with ibuprofen lysine.
Observation:
- A premature infant received ibuprofen lysine for a symptomatic patent ductus arteriosus.
- Following treatment, the infant developed isolated bowel perforations.
Findings:
- This case presents the first reported instance of spontaneous bowel perforation linked to ibuprofen lysine treatment.
- The adverse event occurred despite ibuprofen lysine not having prior reports of this specific complication.
Implications:
- Clinicians should be aware of the potential for gastrointestinal complications, including bowel perforation, with ibuprofen lysine use in neonates.
- Further investigation into the mechanisms and incidence of this rare adverse effect is warranted.
- This finding may influence treatment guidelines and risk-benefit assessments for neonatal patent ductus arteriosus management.
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