Liver penetration by a duodenal ulcer in a young woman.
Liver penetration is a rare but serious complication of peptic ulcer disease. We report a case of a 33-year-old woman who took large doses of nonsteroidal antiinflammatory drugs and developed a giant duodenal ulcer that penetrated into her liver. The diagnosis was based on histologic examination of endoscopic biopsies. She was initially treated with a proton pump inhibitor, but, within 5 weeks, she developed a symptomatic postbulbar stricture that required surgical correction. We also review 11 other reported cases of endoscopically and histologically diagnosed peptic ulcer penetration into the liver.
Novacek
G
G
Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, University of Waeringer Guertel 18/20, A-1090 Vienna, Austria. Gottfried.Novacek@akh-wien.ac.at
Geppert
A
A
Kramer
L
L
Wrba
F
F
Herbst
F
F
Schima
W
W
Gangl
A
A
Pötzi
R
R
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects*; D004381:Duodenal Ulcer / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D004384:Duodenoscopy; D004386:Duodenum / Q000473:pathology; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007405:Intervertebral Disc Displacement / Q000188:drug therapy*; D007633:Keratins / Q000032:analysis; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology / Q000601:surgery; D008111:Liver Function Tests; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced / Q000473:pathology / Q000601:surgery; D010439:Peptic Ulcer Perforation / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D007633:Keratins