Skip to main content
NCBI home page
Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1991 Nov;73(6):337–340.

Non-steroidal anti-inflammatory drugs and stercoral perforation of the colon.

J Hollingworth 1, J Alexander-Williams 1
PMCID: PMC2499448  PMID: 1759759

Abstract

Within 6 months, three constipated patients have been seen with stercoral perforation of the colon associated with the ingestion of non-steroidal anti-inflammatory drug medications (NSAIDs). These drugs were taken regularly for painful musculoskeletal disorders 6, 8 and 12 months before admission. Constipation is thought to be the most significant contributory factor in the development of colonic stercoral perforation; however, it is unclear why it develops in so few of the many patients with severe constipation. NSAID medications have been associated with the perforation of colonic diverticula, but there are no reports of an association with stercoral perforations. If our finding of the association is substantiated by other reports there may be a need for greater awareness of lower gastrointestinal problems when prescribing such drugs to constipated patients.

Full text

PDF
337

Images in this article

338Figure 1
on p.338

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aguilo J. J., Zincke H., Woods J. E., Buckingham J. M. Intestinal perforation due to fecal impaction after renal transplantation. J Urol. 1976 Aug;116(2):153–155. doi: 10.1016/s0022-5347(17)58726-1. [DOI] [PubMed] [Google Scholar]
  2. Bjarnason I., Zanelli G., Smith T., Prouse P., Williams P., Smethurst P., Delacey G., Gumpel M. J., Levi A. J. Nonsteroidal antiinflammatory drug-induced intestinal inflammation in humans. Gastroenterology. 1987 Sep;93(3):480–489. doi: 10.1016/0016-5085(87)90909-7. [DOI] [PubMed] [Google Scholar]
  3. Cass A. J. Stercoral perforation: case of drug-induced impaction. Br Med J. 1978 Sep 30;2(6142):932–933. doi: 10.1136/bmj.2.6142.932-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cid A. A., Pietruk T., Bidari C. Z., Ehrinpreis M. N. Cecal fecaloma mimicking colonic neoplasm. Dig Dis Sci. 1981 Dec;26(12):1134–1137. doi: 10.1007/BF01295981. [DOI] [PubMed] [Google Scholar]
  5. Corder A. Steroids, non-steroidal anti-inflammatory drugs, and serious septic complications of diverticular disease. Br Med J (Clin Res Ed) 1987 Nov 14;295(6608):1238–1238. doi: 10.1136/bmj.295.6608.1238. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Coutrot S., Roland D., Barbier J., Van Der Marcq P., Alcalay M., Matuchansky C. Acute perforation of colonic diverticula associated with short-term indomethacin. Lancet. 1978 Nov 11;2(8098):1055–1056. doi: 10.1016/s0140-6736(78)92385-1. [DOI] [PubMed] [Google Scholar]
  7. Day T. K. Intestinal perforation associated with osmotic slow release indomethacin capsules. Br Med J (Clin Res Ed) 1983 Dec 3;287(6406):1671–1672. doi: 10.1136/bmj.287.6406.1671-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. GRINVALSKY H. T., BOWERMAN C. I. Stercoraceous ulcers of the colon: relatively neglected medical and surgical problem. J Am Med Assoc. 1959 Dec 5;171:1941–1946. doi: 10.1001/jama.1959.03010320031008. [DOI] [PubMed] [Google Scholar]
  9. Gekas P., Schuster M. M. Stercoral perforation of the colon: case report and review of the literature. Gastroenterology. 1981 May;80(5 Pt 1):1054–1058. [PubMed] [Google Scholar]
  10. Langman M. J., Morgan L., Worrall A. Use of anti-inflammatory drugs by patients admitted with small or large bowel perforations and haemorrhage. Br Med J (Clin Res Ed) 1985 Feb 2;290(6465):347–349. doi: 10.1136/bmj.290.6465.347. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Robert A. An intestinal disease produced experimentally by a prostaglandin deficiency. Gastroenterology. 1975 Oct;69(4):1045–1047. [PubMed] [Google Scholar]
  12. SUCKLING P. V. The ball-valve rectum due to impacted faeces. Lancet. 1962 Dec 1;2(7266):1147–1147. doi: 10.1016/s0140-6736(62)90903-0. [DOI] [PubMed] [Google Scholar]
  13. Schneider H. T., Nuernberg B., Dietzel K., Brune K. Biliary elimination of non-steroidal anti-inflammatory drugs in patients. Br J Clin Pharmacol. 1990 Jan;29(1):127–131. doi: 10.1111/j.1365-2125.1990.tb03613.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Serpell J. W., Nicholls R. J. Stercoral perforation of the colon. Br J Surg. 1990 Dec;77(12):1325–1329. doi: 10.1002/bjs.1800771204. [DOI] [PubMed] [Google Scholar]
  15. Stringer M. D., Greenfield S., McIrvine A. J. Stercoral perforation of the colon following postoperative analgesia. J R Soc Med. 1987 Feb;80(2):115–116. doi: 10.1177/014107688708000217. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England

RESOURCES