INTESTINE Vol.13 No.5(4-3-1)

Theme The newest approach to the small intestinal diseases
Title Clinical features and endoscopic finding of NSAIDs induced ulcer in small intestine
Publish Date 2009/09
Author Takeshi Yamamura Department of Gastroenterology, Nagoya University Graduate School of Medicine
Author Naoki Ohmiya Department of Gastroenterology, Nagoya University Graduate School of Medicine
Author Masanao Nakamura Department of Gastroenterology, Nagoya University Graduate School of Medicine
Author Osamu Shirai Department of Gastroenterology, Nagoya University Graduate School of Medicine
Author Hiroyuki Takenaka Department of Gastroenterology, Nagoya University Graduate School of Medicine
Author Kenji Morishima Department of Gastroenterology, Nagoya University Graduate School of Medicine
Author Ryouji Miyahara Department of Endoscopy, Nagoya University Hospital
Author Takafumi Ando Department of Gastroenterology, Nagoya University Graduate School of Medicine
Author Hidemi Goto Department of Gastroenterology, Nagoya University Graduate School of Medicine
[ Summary ] Using double balloon endoscopy (DBE), 16 cases were diagnosed where non-steroidal anti-inflammatory drugs (NSAIDs) had induced ulcers in the small intestine. Diverse types of NSAIDs had been taken for various indications. Periods NSAIDs were taken ranged from 2 months to 10 years. Even if NSAIDs were not taken regularly, some patients had NSAIDs induced ulcers when NSAIDs were administered over periods of several years. The characteristic findings observed with DBE were circular ulcers and diaphragm-like strictures. Moreover, it was found that most cases exhibited multiple lesions. Images of cytolytic reactions and apoptosis in the base of the mucosa were reported as the haracteristic histological findings of NSAIDs induced ulcers. Those fi ndings were obtained in 2 out of 15 cases (13%), which had diaphragm like strictures.
Balloon dilation procedures during DBE were performed in 2 cases which had diaphragm like strictures which the DBE instrument could not pass. DBE was useful for the diagnosis and treatment of NSAIDs induced ulcers.
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