title: Multiple indomethacin-induced colonic perforations in an adolescent.
abstract: Colonic perforation is an uncommon cause of acute abdomen in paediatric patients, and can present a diagnostic enigma as well as management challenge to the paediatric surgeon. An adolescent developed multiple colonic perforations following a short course of oral indomethacin, requiring emergency hemicolectomy. This is the youngest known case of enteral non-steroidal anti-inflammatory drug (NSAID)-mediated large bowel injury. We review current evidence on NSAID-related enteropathy, and postulate potentiating mechanisms that may have accounted for the unusually rapid clinical course of our patient.
authors.affiliation: Department of Paediatric Surgery, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899. amos.loh.hp@kkh.com.sg
authors.forename: A H P
authors.initials: AH
authors.lastname: Loh
authors.forename: L Y
authors.initials: LY
authors.lastname: Ong
authors.forename: W K
authors.initials: WK
authors.lastname: Liew
authors.forename: T
authors.initials: T
authors.lastname: Arkachaisri
authors.forename: V K M
authors.initials: VK
authors.lastname: Lee
authors.forename: K L
authors.initials: KL
authors.lastname: Narasimhan
authors.forename: A S
authors.initials: AS
authors.lastname: Jacobsen
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis; D000284:Administration, Oral; D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000494:pharmacology*; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000187:drug effects*; D003108:Colonic Diseases / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000009:adverse effects*; D007416:Intestinal Perforation / Q000139:chemically induced; D007511:Ischemia / Q000473:pathology; D009336:Necrosis; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin