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[Acute necrotizing enterocolitis during a prolonged treatment with neuroleptics]
1Service de Réanimation médicale et Maladies infectieuses, Centre Hospitalier de Tourcoing.
Presse Medicale (Paris, France : 1983)
|March 25, 1995
Summary
Phenothiazine treatment for chronic psychosis can lead to acute necrotizing colitis, a severe gastrointestinal condition. This case highlights the potential neuroleptic-induced toxicity requiring emergency surgery.
Area of Science:
- Gastroenterology
- Psychiatry
- Pharmacology
Background:
- Chronic psychosis management often involves long-term neuroleptic medication.
- Phenothiazines are a class of antipsychotic drugs used to treat psychosis.
- Gastrointestinal complications of neuroleptic use are rare but can be severe.
Observation:
- A 32-year-old male patient on long-term phenothiazine therapy for chronic psychosis presented with acute abdominal symptoms.
- Clinical examination and subsequent investigations revealed acute necrotizing colitis.
Findings:
- Histological examination showed extensive mucosal necrosis without signs of stenosis or mesenteric vascular compromise.
- The absence of alternative treatments and the specific pathological findings strongly suggested a causal link to phenothiazine use.
- The patient underwent emergency total colectomy due to the severity of the colitis.
Implications:
- This case underscores the potential for severe gastrointestinal adverse effects from phenothiazine antipsychotics.
- Clinicians should maintain a high index of suspicion for drug-induced colitis in patients on neuroleptic therapy presenting with abdominal distress.
- Further research into the mechanisms of neuroleptic-induced gastrointestinal toxicity is warranted.