RESUMEN
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.
Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas , Diclofenaco/efectos adversos , Úlcera Duodenal/inducido químicamente , Desplazamiento del Disco Intervertebral/tratamiento farmacológico , Úlcera Péptica Perforada/inducido químicamente , Adulto , Antiinflamatorios no Esteroideos/administración & dosificación , Diclofenaco/administración & dosificación , Úlcera Duodenal/patología , Úlcera Duodenal/cirugía , Duodenoscopía , Duodeno/patología , Femenino , Humanos , Técnicas para Inmunoenzimas , Queratinas/análisis , Hígado/patología , Hepatopatías/patología , Hepatopatías/cirugía , Pruebas de Función Hepática , Úlcera Péptica Hemorrágica/inducido químicamente , Úlcera Péptica Hemorrágica/patología , Úlcera Péptica Hemorrágica/cirugía , Úlcera Péptica Perforada/patología , Úlcera Péptica Perforada/cirugíaRESUMEN
The effects of a new microencapsulated potassium chloride formulation on upper gastrointestinal tract mucosa was compared with that of a popular wax-matrix formulation in 48 healthy volunteers. After a week of KCl, subjects were gastroscoped, the endoscopist being blind to the type of preparation taken. Wax-matrix formulations were associated with a higher incidence of upper gastrointestinal lesions. The lesions were not accompanied by epigastric symptoms. Glycopyrrolate, given to some volunteers to decrease gastric emptying, aggravated the effects of potassium chloride.