NSAIDS induced gastric perforation
Abstract
Background: Acute gastric perforation (AGP) is a sudden and severe emergent condition with increased morbidity and mortality from associated peritonitis and systemic derangements. Non-steroidal anti-inflammatory drugs (NSAIDs) are known to cause of this disease. Most patients with AGP present late to hospital and require prompt correction of metabolic derangements and urgent surgical repair of the perforation and treatment of associated peritonitis.
Aim: To audit and characterize patients with a clinical and operative diagnosis of NSAIDs induced acute gastric perforation.
Methods: A prospective observational study of patients presenting in the emergency room with acute abdomen and a clinical diagnosis of NSAIDs induced gastric perforation, confirmed intra-operatively. Information was analysed with SPSS 17 (SPSS Statistics for Windows, Chicago, USA) using descriptive statistics and presented as percentages and tables.
Result: There were 16 patients diagnosed with NSAIDS induced gastric perforation, 14 males (87.5%) and 2 females (12.5%). Twelve (68%) cases occurred at 50 years and below. One patient underwent reoperation for failed repair. Six deaths (37.5% mortality) were recorded. All the patients presented in shock with deranged biochemical parameters. The perforations were in the gastric antrum. Peritonitis was common.
Conclusion: Gastric perforation from NSAIDs is an important differential of acute abdomen, affecting predominantly males in Uyo, with nearly 80% involving young and middle-aged individuals. Acute kidney injury is a common association.
Keywords: Acute gastric perforation, NSAIDs, Renal injury, High morbidity.
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