NSAID-Induced Lower Gastrointestinal Bleeding: A Case Report

Abstract

Abstract Nonsteroidal anti-inflammatory drugs (NSAIDs) are well known to cause ulcers and bleeding in the upper gastrointestinal tract. Furthermore, several studies to date have demonstrated that NSAIDs may also cause ulcers in the lower gastrointestinal tract, or the bowel, resulting in small bowel bleeding. The diagnosis and management of bleeding in the small bowel region pose a significant challenge. Here, we present the case of a 30-year-old female who presented to the hospital with lower gastrointestinal bleeding after taking an NSAID for a prolonged period. The results of all investigations, including computed tomography angiography, esophagogastroduodenoscopy, colonoscopy, and digital subtraction angiography, were negative. The patient was transferred to the operating room for an on-table colonoscopy and surgical intervention because of continuous bleeding and hemodynamic instability. During the operation, a suspected bleeding site was located in the terminal ileum, leading to the resection of the small bowel, which revealed ulcerative lesions. NSAIDs are believed to have caused the ulcer in this patient, as evidenced by all the available information, including the pathological results.