Drug related colonic perforation: Case report

Background: Acute pseudo-obstruction of the colon is a disorder characterised by an increase in intra-luminal pressure that leads to ischaemia and necrosis of the intestinal wall. The mechanism that produces the lesion is unknown, although it has been associated with: trauma, anaesthesia, or drugs that alter the autonomic nervous system. The pathophysiology of medication induced colon toxicity can progress to a perforated colon and potentially death. Objetive: Present a case of a colonic pseudo-obstruction in a patient with polyfarmacy as the only risk factor and to review the medical literature related to the treatment of this pathology. Clinical case: The case is presented of a 67 year old woman with colonic pseudo-obstruction who presented with diffuse abdominal pain and distension. The pain progressed and reached an intensity of 8/10, and was accompanied by fever and tachycardia. There was evidence of free intraperitoneal air in the radiological studies. The only risk factor was the use of multiple drugs. The colonic pseudo-obstruction progressed to intestinal perforation, requiring surgical treatment, which resolved the problem successfully. Conclusion: It is important to consider drug interaction in patients with multiple diseases, as it may develop complications that can be avoided if detected on time. (C) 2015 Academia Mexicana de Cirugia A.C. Published by Masson Doyma Mexico S.A.