2021 Volume 63 Issue 4 Pages 415-422
A 67-year-old woman developed palpitation four days after starting oral administration of ibuprofen for dental caries. She went to a local clinic where a blood test was performed. She was found to have anemia and was referred to our hospital. After detailed investigation of anemia was performed, she was emergently admitted to our hospital. A blood transfusion was administered on hospital day 1 and her anemia improved on hospital day 2. Findings of upper endoscopy performed on hospital day 1 and colonoscopy performed on hospital day 3 were normal. Her medical history and imaging findings did not indicate intestinal stenosis. However, capsule endoscopy (CE) performed on hospital day 6 revealed a stenotic region accompanied by an ulcer at the distal portion of the ileum, resulting in capsule retention. Abdominal pain and nausea developed two days after CE, and small bowel obstruction due to capsule retention was diagnosed. Two days after insertion of an ileus tube, the capsule was excreted spontaneously. She was discharged from the hospital on hospital day 16. Eighteen weeks after discontinuing ibuprofen, retrograde single-balloon enteroscopy revealed a healed ulcer and the patient was diagnosed with a small intestinal ulcer induced by a nonsteroidal anti-inflammatory drug (NSAID). Endoscopists should carefully consider whether to perform CE in patients who are taking an NSAID regardless of the duration of administration, since acute edematous small intestinal stenosis could be caused by the formation of an intestinal ulcer induced by short-term administration of NSAIDs.
