ABSTRACT
A 35 year old woman with past medical history of hypertension presented to the emergency department with chief complaint of severe abdominal pain for one week. The abdominal pain was located in the epigastrium and described as "cramping" and "intermittent". The pain intensity was quantified initially as 6 out of 10 on the pain scale. As the week progressed the pain became constant and radiated to the back. The intensity of the abdominal pain increased to 10 out of 10. The patient reported some relief from her pain while lying in the prone position. Initially the pain was associated with loose stools for several days. The loose stools resolved spontaneously and then the patient began to experience nausea and vomiting. Her medications included lisinopril-hydrochlorothiazide which she had been taking for the past five months. She had no history of alcohol, tobacco or illicit drug use.
Subject(s)
Abdominal Pain/etiology , Hydrochlorothiazide/therapeutic use , Lisinopril/therapeutic use , Pancreatitis, Acute Necrotizing/diagnostic imaging , Pancreatitis, Acute Necrotizing/therapy , Adult , Drainage , Drug Combinations , Female , Humans , Hypertension , Pain Measurement , Tomography, X-Ray ComputedSubject(s)
Abdominal Pain , Jaundice, Obstructive , Liver Cirrhosis, Biliary , Tomography, X-Ray Computed , Abdominal Pain/blood , Abdominal Pain/diagnostic imaging , Abdominal Pain/etiology , Adult , Female , Humans , Jaundice, Obstructive/blood , Jaundice, Obstructive/diagnostic imaging , Jaundice, Obstructive/etiology , Liver Cirrhosis, Biliary/blood , Liver Cirrhosis, Biliary/complications , Liver Cirrhosis, Biliary/diagnostic imagingABSTRACT
This paper describes a rare case in which the oral administration of mesalamine resulted in the exacerbation of ulcerative colitis (UC) in a patient who was previously responsive to mesalamine and whose colitis had been in remission for eight years. Mesalamine and other 5-aminosalicylic acid compounds are the mainstay of treatment for UC; however up to 8% of patients are unable to take the medications due to intolerance or hypersensitivity reactions. Common drug reactions are fever, nausea, diarrhea and abdominal pain; however, exacerbation of UC has rarely been reported. This study highlights the importance of ruling out mesalamine as the causative agent in cases of UC exacerbations.
