Erkin ÖZTAŞ, Meral AKDOĞAN, Diğdem Özer ETİK, İsmail Hakkı KALKAN, Abdurrahim SAYILIR, Sedef KURAN, Burçak KAYHAN

Asetil salisilik asit kullanımına bağlı oluşan ileoçekal valv ülserleri ve deformasyonu sonucunda gelişen çekumda çift lümen görünümü

Günümüzde; non steroidal anti-inflamatuvar ilaçların, özellikle aspirinin kullanımı yaşlanma ve yaşlanmayla ilişkili kardiyovasküler hastalıkların sıklığındaki artışla birlikte giderek artmaktadır. Aspirinin; gastroduodenal mukozal hasar yapıcı etkisi gibi en iyi bilinen yan etkisinin yanında yine aspirin nedeniyle oluşan intestinal hasar da daha sık karşımıza çıkmaktadır. Burada muhtemelen enterik-kaplı asetil salisilik asit kullanımı nedeniyle oluşan rekürran ülserlere bağlı gelişen ileoçekal valv deformasyonlu olguyu sunuyoruz.

Anahtar Kelimeler:

Kolonoskopi, intestinal ülserler, enterik-kaplı asetil sali silik asit

Double lumen appearance of the cecum presumably caused by acetyl salicylic acidinduced ileocecal valve ulcers and deformation

The use of non-steroidal anti-inflammatory drugs, especially aspirin, has continued to increase with aging and related cardiovascular diseases. Since their well-known side effect is gastroduodenal mucosal injury, aspirin-induced intestinal damage has also become a growing problem. Herein, we present a case with an advanced anatomical impairment of the ileocecal valve deformation, presumably caused by enteric-coated acetyl salicylic acid induced recurrent ulcers.

Keywords:

Colonoscopy, intestinal ulcers, enteric-coated acetyl salicylic acid,

PDF

___

Higuchi K, Umegaki E, Watanabe T, et al.. Present status and strategy of NSAIDs-induced small bowel injury. J Gastroenterol 2009; 44: 879-88.
Bjarnason I, Price AB, Zanelli G, et al. Clinicopathological features of nonsteroidal antiinflammatory drug-induced small intestinal strictures. Gastroenterology 1988; 94: 1070-4.
Lang J, Price AB, Levi AJ, Burke M, Gumpel JM, Bjarnason I. Diaphragm disease: pathology of disease of the small intestine induced by non- steroidal anti-inflammatory drugs. J Clin Pathol 1988; 41: 516-26.
Matsuhashi N, Yamada A, Hiraishi M, et al. Multiple strictures of the small intestine after long-term non-steroidal anti-inflammatory drug therapy. Am J Gastroenterol.1992; 87: 1183-6.
Fellows IW, Clarke JM, Roberts PF. Non-steroidal anti-inflammatory drug-induced jejuna and colonic diaphragm disease. A report of two cases. Gut 1992; 33: 1424-6.
Robert A, Asano T. Resistance of germ-free rats to indomethacin induced intestinal inflammation. Prostaglandins 1977; 14: 333-41.
Fang WF, Broughton A, Jacobson ED. Indomethacin induced intestinal inflammation. Am J Dig Dis 1977; 22: 749-60.
Whittle BJ. Temporal relationship between cyclooxygenase inhibition, as measured by prostacyclin biosynthesis, and the gastrointestinal damage induced by indomethacin in the rat. Gastroenterology 1981; 80: 94-8.
Bjarnason I, Hayllar J, MacPherson AJ, Russell AS. Side effects of nons- teroidal anti-inflammatory drugs on the small intestine in humans. Gastroenterology 1993; 104: 1832-47. 10-Yamada T, Deitch E, Specian RD, Perry MA, Sartor RB, Grisham MB. Mechanisms of acute and chron- ic intestinal inflammation induced by indomethacin. Inflammation 1993; 17: 641-62.
Bjarnason I, Hayllar J, Smethurst P, Price A, Gumpel MJ. Metronidazole reduces intestinal inflammation and blood loss in non-steroidal anti- inflammatory drug induced enteropathy. Gut 1992; 33: 1204-8.
Hayllar J, Smith T, Macpherson A, Price AB, Gumpel M, Bjarnason I. Nonsteroidal anti-inflammatory drug-induced small intestinal inflamma- tion and blood loss: effects of sulfasalazine and other disease-modifying antirheumatic drugs. Arthritis Rheum 1994; 37: 1146-50.
Morris AJ, Murray L, Sturrock RD, et al. Short report: the effect of miso- prostol on the anaemia of NSAID enteropathy. Aliment Pharmacol Ther 1994; 8: 343-6.
Hawkey CJ, Karrasch JA, Szczepañski L, et al. Omeprazole compared with misoprostol for ulcers associated with nonsteroidal anti-inflamma- tory drugs. Omeprazole versus Misoprostol for NSAID-induced Ulcer Management (OMNIUM) Study Group. N Engl J Med 1998; 338: 727- 34.