因未披露使用双氯芬酸乙胺贴剂导致的难治性胃溃疡。
Refractory gastric ulcer due to undisclosed use of topical diclofenac epolamine patches.
作者信息
Oda Yuta, Naito Hiromichi, Nojima Tsuyoshi, Nakao Atsunori
机构信息
Dentistry and Pharmaceutical Sciences Department of Emergency Critical Care, and Disaster Medicine Okayama University Graduate School of Medicine Okayama Japan.
出版信息
Acute Med Surg. 2021 Nov 20;8(1):e710. doi: 10.1002/ams2.710. eCollection 2021 Jan-Dec.
BACKGROUND
Topical forms of nonsteroidal anti-inflammatory drugs (NSAIDs) have been created to lessen systemic adverse effects. In general, they are believed to be well tolerated and appropriate for use as an over-the-counter (OTC) drug.
CASE PRESENTATION
A 68-year-old woman visited our clinic due to tarry stool. The patient reported multiple episodes of recurrent bleeding from a gastric ulcer for 2 months and was treated with endoscopic hemostatic clipping. The patient disclosed she had been using a large number of diclofenac patches for more than 3 months. The patient was treated conservatively by discontinuation of diclofenac patches and treatment with a proton pump inhibitor and omeprazole.
CONCLUSION
In conclusion, inappropriate use of topical NSAID patches can be a cause of peptic ulcer bleeding. Patients reporting multiple episodes of recurrent bleeding from a gastric ulcer should be questioned, particularly about the use of OTC medications that might include topical NSAID patches.
背景
非甾体抗炎药（NSAIDs）的局部剂型已被研发出来以减轻全身不良反应。一般认为，它们耐受性良好，适合作为非处方药（OTC）使用。
病例介绍
一名68岁女性因柏油样便前来我院就诊。患者报告称，胃溃疡反复出血达2个月，曾接受内镜止血夹闭治疗。患者透露，她使用大量双氯芬酸贴片已超过3个月。通过停用双氯芬酸贴片，并使用质子泵抑制剂奥美拉唑进行保守治疗。
结论
总之，局部使用NSAID贴片不当可能是消化性溃疡出血的一个原因。对于报告胃溃疡反复出血的患者，应进行询问，特别是关于可能包括局部NSAID贴片在内的非处方药的使用情况。
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