title: [Drug related colonic perforation: Case report].
abstract: BACKGROUND
  Acute pseudo-obstruction of the colon is a disorder characterised by an increase in intra-luminal pressure that leads to ischaemia and necrosis of the intestinal wall. The mechanism that produces the lesion is unknown, although it has been associated with: trauma, anaesthesia, or drugs that alter the autonomic nervous system. The pathophysiology of medication induced colon toxicity can progress to a perforated colon and potentially death.
  
  
  OBJECTIVE
  Present a case of a colonic pseudo-obstruction in a patient with polypharmacy as the only risk factor and to review the medical literature related to the treatment of this pathology.
  
  
  METHODS
  The case is presented of a 67 year old woman with colonic pseudo-obstruction who presented with diffuse abdominal pain and distension. The pain progressed and reached an intensity of 8/10, and was accompanied by fever and tachycardia. There was evidence of free intraperitoneal air in the radiological studies. The only risk factor was the use of multiple drugs. The colonic pseudo-obstruction progressed to intestinal perforation, requiring surgical treatment, which resolved the problem successfully.
  
  
  CONCLUSIONS
  It is important to consider drug interaction in patients with multiple diseases, as it may develop complications that can be avoided if detected on time.
authors.affiliation: Servicio de Cirugía General, Centro Médico ABC, México D.F. , México. Electronic address: edgar.nunez.g@gmail.com.
authors.forename: Edgar
authors.initials: E
authors.lastname: Núñez-García
authors.affiliation: Servicio de Cirugía General, Centro Médico ABC, México D.F. , México.
authors.forename: Luis César
authors.initials: LC
authors.lastname: Valencia-García
authors.affiliation: Servicio de Cirugía General, Centro Médico ABC, México D.F. , México.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Sordo-Mejía
authors.affiliation: Servicio de Cirugía General, Centro Médico ABC, México D.F. , México.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kajomovitz-Bialostozky
authors.affiliation: Servicio de Cirugía General, Centro Médico ABC, México D.F. , México.
authors.forename: Alberto
authors.initials: A
authors.lastname: Chousleb-Kalach
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use; D000069059:Atorvastatin / Q000009:adverse effects / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D003106:Colon / Q000601:surgery; D012809:Colon, Sigmoid / Q000601:surgery; D003112:Colonic Pseudo-Obstruction / Q000139:chemically induced* / Q000503:physiopathology / Q000601:surgery; D004357:Drug Synergism; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D007082:Ileum / Q000601:surgery; D007416:Intestinal Perforation / Q000209:etiology* / Q000601:surgery; D007654:Ketoconazole / Q000627:therapeutic use; D000077287:Levetiracetam; D000077731:Meropenem; D009543:Nifedipine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D019338:Polypharmacy; D000069348:Quetiapine Fumarate / Q000009:adverse effects / Q000627:therapeutic use; D020849:Raloxifene Hydrochloride / Q000009:adverse effects / Q000627:therapeutic use; D012121:Respiration, Artificial; D012307:Risk Factors; D013845:Thienamycins / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D018680:Cholinergic Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D013845:Thienamycins; D000069348:Quetiapine Fumarate; D000077287:Levetiracetam; D020849:Raloxifene Hydrochloride; D000069059:Atorvastatin; D000077731:Meropenem; D009543:Nifedipine; D007654:Ketoconazole; D010889:Piracetam
keywords: Colonic pseudo-obstruction; Drugs; Fármacos; Intestinal perforation; Multiple medications; Perforación intestinal; Polifarmacia; Pseudo-obstrucción colónica