Gastrointestinal perforation: relation to corticosteroid use and COPD - a case report.
Michael H K Nguyen1, Krista M Isaac2, Rebecca Dougherty2
1Department of Internal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA; Michael.Nguyen@jefferson.edu.
Journal of Community Hospital Internal Medicine Perspectives
|September 10, 2016
Summary
Gastrointestinal perforations, a complication of duodenal ulcers, can be linked to corticosteroid use, especially during chronic obstructive pulmonary disease (COPD) exacerbations. This case highlights the risk of acute duodenal ulcer perforation in patients treated with corticosteroids for COPD.
Area of Science:
- Gastroenterology
- Pulmonology
- Pharmacology
Background:
- Gastrointestinal perforations complicate 2-10% of duodenal ulcers.
- Corticosteroids, NSAIDs, and opioids are medications associated with duodenal ulcer perforation.
- Chronic obstructive pulmonary disease (COPD) is frequently associated with peptic ulcer disease, affecting up to 30% of patients.
Observation:
- This report details a case of acute duodenal ulcer perforation.
- The patient was undergoing corticosteroid treatment for an acute COPD exacerbation.
Findings:
- Corticosteroid use is a known risk factor for duodenal ulcer perforation.
- The combination of COPD and corticosteroid treatment may increase the risk of acute duodenal ulcer perforation.
Implications:
- Clinicians should be aware of the increased risk of gastrointestinal complications in COPD patients, particularly those on corticosteroids.
- Further research may be warranted to elucidate the specific mechanisms linking COPD, corticosteroid therapy, and duodenal ulcer perforation.
