Résumé
A patient on treatment for multibacillary leprosy for the past three years, presented with episodes of abdominal pain. Since the patient improved with conservative management, clofazimine induced enteropathy was considered as a remote possibility. A review of the mucosal biopsies showed macrophages with crystal-storing spaces consistent with clofazimine deposition in the duodenum. This case highlights the need to consider and investigate drug-induced disease as part of the differential diagnosis.
Sujets)
Clofazimine/effets indésirables , Maladies du duodénum/induit chimiquement , Gastrite atrophique/induit chimiquement , Humains , Antilépreux/effets indésirables , Lèpre lépromateuse/traitement médicamenteux , Mâle , Adulte d'âge moyenRésumé
We present a 55 years old male with severe anemia with history of pain abdomen for 2 weeks and malena of 10 days duration. He was taking NSAID (Diclofenac sodium). Upper GI endoscopy done twice did not reveal any abnormality. Upper gastrointestinal (UGI) barium series with small bowel follow through revealed a diverticulum on medial wall of second part of duodenum and there was evidence of ulcer in diverticulum. He underwent diverticulectomy. On follow up after 6 months patient was asymptomatic.
Sujets)
Anti-inflammatoires non stéroïdiens/usage thérapeutique , Diclofenac/effets indésirables , Diverticule/induit chimiquement , Maladies du duodénum/induit chimiquement , Radioscopie , Hémorragie gastro-intestinale/induit chimiquement , Humains , Lombalgie/traitement médicamenteux , Mâle , Adulte d'âge moyenRésumé
BACKGROUND: Spontaneous intramural hemorrhage of the duodenum due to anticoagulant therapy is rare and the treatment is controversial. OBJECTIVE: To present the acquired knowledge with the treatment of these disease. CASE REPORT: A 71-year-old women receiving for a 3 month period an anticoagulant therapy presented cervical bleeding of soft tissues and symptoms of acute pancreatitis and high small bowel obstruction. Early noninvasive diagnosis by computed tomographic scan was possible and conservative therapy proved successful in complete resolution of the pancreatitis and obstructive symptoms, with resumption of oral intake in the fourth day of treatment. The frequency of bleeding in high risk patients during warfarin therapy is reduced by less intense therapy, achieving a prothrombin time with an International Normalized Ratio of 2.0 to 3.0. RESULTS: The use of conservative treatment was helpful and the patient was discharged asymptomatic, 10 days after admission. CONCLUSION: It is suggested conservative treatment for intramu