NSAID-induced pyloric stenosis leading to oesophageal intramucosal dissection

Kai Rou Tey, Thomas Kemmerly, Bhaskar Banerjee

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Abstract

We describe a rare case of a 75-year-old woman with significant non-steroidal anti-inflammatory drug (NSAID) use who presented with haematemesis. Upper endoscopy revealed a large (9 cm) intramucosal dissection of the oesophagus without extension into the gastro-oesophageal junction and a severely narrowed pylorus. We postulate that she developed pyloric stenosis due to peptic ulcer disease from chronic NSAID use. This then led to gastro-oesophageal reflux. Undigested pills in the refluxate had contacted oesophageal mucosa, leading to pill-induced oesophageal injury. This, along with vomiting, is postulated to have led to the oesophageal intramucosal dissection. She improved with conservative medical management with a clear liquid diet and proton pump inhibitors, and a follow-up upper endoscopy 1 week later showed recovery of the previously seen intramucosal dissection.

Original languageEnglish (US)
Article number215777
JournalBMJ Case Reports
Volume2016
DOIs
Publication statusPublished - May 19 2016

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ASJC Scopus subject areas

  • Medicine(all)

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