Abstract
An 83-year-old man with melena was transferred to our hospital, and multiple ileal ulcers were revealed by colonoscopy. Low-dose aspirin was suspected as the cause of the ileal ulcers, so aspirin was stopped. During hospitalization, the patient developed a high grade fever and several sets of laboratory studies showed severe leukocytosis and increased C-reactive protein. Colonoscopy showed that the ileal ulcers had almost healed. Fifty-three days after admission, celecoxib 200 mg per day was initiated for relief of severe low back pain due to lumbar spinal stenosis. Seventy-eight days after admission, severe abdominal pain occurred and abdominal computed tomography showed the presence of free air, so the diagnosis of a gastrointestinal perforation was made. An operation was performed and 10 punched-out perforations were found in the terminal ileum. Pathological findings showed non-specific inflammation in the ileum, so the association between celecoxib and multiple ileal ulcers was suspected. We report herein on a case of NSAIDs-induced multiple ileal ulcers complicated by multiple perforation.
