Gastric Ulcer Perforation Associated with the Use of Injectable Ketorolac

1993 ◽  
Vol 27 (1) ◽  
pp. 42-43 ◽  
Author(s):  
Lynn L. Estes ◽  
David W. Fuhs ◽  
Alan H. Heaton ◽  
Conrad S. Butwinick

OBJECTIVE: To report a case of a perforated gastric ulcer associated with the use of injectable ketorolac tromethamine. DATA SYNTHESIS: A 77-year-old woman with no previous history of peptic ulcer disease developed a perforated gastric ulcer after four days of treatment with ketorolac. To date, six other cases of gastrointestinal (GI) perforation associated with the use of ketorolac have been reported to the manufacturer. CONCLUSIONS: Although ketorolac is an effective analgesic, it is a nonsteroidal antiinflammatory agent and thus has the propensity for causing GI ulceration. Caution should be used when administering this drug and patients should be monitored for GI adverse effects.

2021 ◽  
Vol 8 (8) ◽  
pp. 2505
Author(s):  
Abhirup H. R. ◽  
Priyanka Kenchetty ◽  
Aishwarya K. Chidananda

Phytobezoar which is described as an undigested or incompletely digested food. It is an odd cause of gastric outlet obstruction (GOO). The aim of this study is to present and discuss a case of GOO caused by cicatrised duodenal ulcer with a phytobezoar. 71-year-old male, presented with abdominal pain and vomiting (non-bilious) since 3days with peptic ulcer disease for 4 years. Examination and investigations revealed a bezoar requiring emergency surgical intervention. An exploratory laparotomy was conducted. A bezoar was palpated in the stomach and removed through posterior gastrotomy. Vagotomy with Posterior Gastrojejunostomy was done as drainage procedure for cicatrised Duodenal ulcer. GOO caused by phytobezoar can co-exist in patients with previous history of peptic ulcer disease and cicatrised duodenal ulcer. Urgent laparotomy may be indicated.


1995 ◽  
Vol 29 (7-8) ◽  
pp. 698-701 ◽  
Author(s):  
James Maliekal ◽  
Charles M Elboim

Objective: To report 3 cases of gastrointestinal (GI) complications associated with the use of intramuscular ketorolac tromethamine therapy in elderly patients. Case Summaries: In case 1, an 88-year-old woman was taken to surgery for the management of an acute abdomen and repair of a 2+ cm perforated prepyloric gastric ulcer. The patient had received a total 16 doses of ketorolac 30 mg im. The patient died after surgery from complications associated with bacterial and candidal sepsis, as well as acute renal failure. In case 2, an 80-year-old woman with no known history of GI problems developed a prepyloric gastric ulcer, which perforated and penetrated into the pancreas after the patient received 13 doses of ketorolac 30 mg im. The patient died from complications associated with candidal sepsis, peritonitis, and cardiopulmonary collapse. In case 3, an 85-year-old man with a history of a gastric ulcer developed GI bleeding after receiving a total of 9 doses of ketorolac 30 mg im. The bleeding was stabilized and the patient was discharged 12 days later in stable condition. Discussion: Ketorolac tromethamine is a nonsteroidal antiinflammatory drug with potent analgesic properties. We report 3 cases of GI complications associated with intramuscular ketorolac therapy in the elderly. A temporal relationship was established with the development of gastric ulceration in 2 patients and the recurrence of a gastric ulcer in the third patient. Conclusions: We recommend that the manufacturer's guidelines be followed when ketorolac is used in elderly patients, and the drug should not be used in patients with a history of gastric ulcer disease. The use of misoprostol may be warranted as prophylactic therapy in high-risk patients who are receiving ketorolac.


PEDIATRICS ◽  
1950 ◽  
Vol 6 (6) ◽  
pp. 897-907
Author(s):  
ARTHUR R. C. COLE

A brief review of the natural history of peptic ulcer in infancy and childhood is given. The symptomatology, differential diagnosis and diagnostic procedures are presented. The diagnosis of peptic ulcer should be considered more often in infancy and childhood and the proper diagnostic procedures instituted. A case of gastric ulcer simulating hypertrophic pyloric stenosis is presented. A summary of 31 cases with peptic ulcers found at autopsy at the Babies Hospital from January 1, 1924 to January 1, 1950 is given. From a summary of coexistent disease found in the autopsy cases at the Babies Hospital and reports from the recent literature, it would appear that diseases of the central nervous, gastrointestinal and respiratory systems are commonly present in cases which have shown peptic ulcer at autopsy.


1985 ◽  
Vol 66 (5) ◽  
pp. 377-377
Author(s):  
N. A. Cherkasova ◽  
H. S. Bikbulatova ◽  
V. N. Leonova

There were 26 patients with gastric ulcer and duodenal ulcer (17 boys, 9 girls) aged from 9 to 18 years under observation.


Author(s):  
Tyler M. Berzin ◽  
Kenneth R. Falchuk

Peptic ulcer disease (PUD) involves the stomach or duodenum and is a significant cause of morbidity and mortality both in the United States and worldwide, with a lifetime prevalence estimated at 5–15%. For a good part of the 20th century PUD was felt to be a condition related to stress and dietary factors. More recently, our understanding of PUD has been advanced by research into the role of gastric acid secretion and the benefits of various classes of antisecretory medications and, perhaps most importantly, in 1984, by Warren and Marshall, who identified Helicobacter pylori (H. pylori) as a pathogenic agent in this disease. Proton pump inhibitor (PPI) therapy and H. pylori eradication regimens have altered the natural history of what once was a chronic disease, and they have also reduced peptic ulcer complications, limiting the need for surgery.


1998 ◽  
Vol 4 (3) ◽  
pp. 135-139 ◽  
Author(s):  
Gh. Jeelani Romshoo ◽  
G. M. Malik ◽  
M. Youssuf Bhat ◽  
Ab. Rashid rather ◽  
Javaid Ahmad Basu ◽  
...  

Aim: To study the association of Helicobacter pylori infection with chronic antral gastritis in peptic ulcer disease patients and healthy population of Kashmir.Methods: 50 peptic ulcer patients (duodenal ulcer = 46, gastric ulcer = 2 and combined duodenal and gastric ulcer = 2) and 30 asymptomatic healthy volunteers were included in this study. Peptic ulcer was diagnosed on endoscopic examination. 4–6 punch biopsies were taken from gastric antrum in all the individuals and in case of gastric ulcer an additional biopsy was taken from the edge of the ulcer to exclude its malignant nature. Helicobacter pylori (H. pylori) organism was diagnosed using three different test methods, viz. Histology (using Giemsa Stain), Microbiology (Gram Stain) and Biochemistry (using one minute Endoscopy Room Test). Histological diagnosis of H. pylori was taken as the “gold standard” for the presence of H. pylori organism. Histological diagnosis of gastritis was made using Hematoxylin and Eosin Stain and the gastritis was classified as active chronic gastritis and superficial chronic gastritis.Results: Out of 30 peptic ulcer disease patients with associated antral gastritis, 27 (90%) were positive for H. pylori on histological examination (13 superficial chronic gastritis and 14 active chronic gastritis) whereas out of 8 healthy volunteers with histological evidence of chronic antral gastritis, H. pylori was observed in 7 individuals (87.50%) (4 active chronic gastritis and 3 superficial chronic gastritis).Conclusion: A highly significant association between H. pylori infection with chronic antral gastritis both in peptic ulcer disease patients and healthy volunteers of Kashmir was found in this study. Association between H. pylori infection and chronic gastritis was 90% in peptic ulcer group and 87.50% in healthy population (P<0.005).


Author(s):  
VAZHA GVANTSELADZE ◽  
NANA GNANTSELADZE

The aim of the study was to study the frequency and nature of episodes of heartburn and bloating in patients with duodenal and gastric ulcers in the Georgian population, considering the histomorphological and morphometric changes of the gastric mucosa and the parameters of gastric secretion. At the same time, we were interested in analyzing patients' anamnesis before being hospitalized for the last 2 months. The analysis of the material showed that incidence of heartburn episodes in the Georgian population is clearly higher in patients with peptic ulcer disease 12 - (79.9%) than in patients with gastric ulcer (9 - 31.9%). Episodes of heartburn in these patients are characterized not only by increasing of rate (more than 50 episodes), both day and night, but the intensity and duration (which is due to abnormal gastroesophageal reflux). This is a high risk for the occurrence of heartburn episodes. As for bloating, it was detected in patients with duodenal ulcer (11–26.2%), in gastric ulcer 11– (32.9%). The main pathogenetic aspects of heartburn episodes were found to be diffuse fundal glands hyperplasia and high acidity (duodenal ulcer and pyloric anterior ulcer). It was also found that a large percentage of patients were not treated properly, leading to impaired ability to work and changes in quality of life and disease progression.


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