Gastric perforation induced by non-steroidal anti-inflammatory drugs: a case report

Authors

  • Julio Caleb Arrieta Navarro Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú. https://orcid.org/0009-0008-6100-2356
  • Nataly Acosta Alava Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú. https://orcid.org/0000-0001-7517-2876
  • Fiorella Ester Apaéstegui Reátegui Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú. https://orcid.org/0000-0002-0284-7155
  • Cesar Alonso Arpasi Sinti Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú. https://orcid.org/0000-0003-3191-8570
  • Milka Malena Prentice Mori Department of Internal Medicine, Hospital II-2 Tarapoto, San Martin-Peru https://orcid.org/0000-0002-3868-5661
  • Heriberto Arévalo Ramírez Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú. / Laboratorio Referencial Regional de Salud Pública de San Martín, Tarapoto, Perú. https://orcid.org/0000-0002-3252-6301
  • Carlos Javier Mego Silva Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú. / Departamento de Cirugía y Especialidades, Servicio de Cirugía, Hospital II-2 Tarapoto. Tarapoto, Perú. https://orcid.org/0000-0003-4788-6155

DOI:

https://doi.org/10.20453/rmh.v36i4.6162

Keywords:

Prostaglandins, Peptic ulcer, gastric acid, Self-medication, Peritonitis, Septic shock

Abstract

Gastric perforation is a serious and potentially fatal complication of prolonged or improper use of non-steroidal anti-inflammatory drugs (NSAIDs). Their primary mechanism involves the inhibition of prostaglandin synthesis, which reduces mucosal protection and promotes the formation of ulcers susceptible to perforation. We report the case of a 30-year-old male who, after taking etoricoxib and then self-medicating with diclofenac for two weeks, developed progressive colicky abdominal pain along with nausea and general malaise. One day prior to admission, the pain suddenly became persistent and severe, accompanied by vomiting, abdominal distension, sweating (diaphoresis), and shortness of breath (dyspnea). On examination, he had a distended abdomen, a positive Blumberg sign (rebound tenderness), and severe epigastric pain. An X-ray showed pneumoperitoneum (air in the abdominal cavity), prompting emergency laparotomy, which revealed a 0.5 cm perforation on the anterior wall of the pylorus. Early intervention prevented peritonitis and septic shock. This case demonstrates that prompt clinical and imaging assessments are crucial for effective management and highlights the importance of education about self-medication to prevent fatal outcomes.

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Author Biographies

Julio Caleb Arrieta Navarro, Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú.

National University of San Martin: Tarapoto, PE 2019 to date | Human Medicine Student (San Martin) Education Show less details ROR Organization Identifiers: https://ror.org/02h7fsz12 National University of San Martin: Tarapoto, PE Other Organization Identifiers provided by ROR GRID: grid.441968.6 (preferred), ISNI: 0000000403963777 WIKIDATA: Q24236924 WIKIPEDIA_URL: Added 2024-07-25 Last Modified 2024-07-25

Nataly Acosta Alava, Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú.

National University of San Martin: Tarapoto, PE 2019 to date | Human Medicine Student (San Martin) Education

Fiorella Ester Apaéstegui Reátegui , Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú.

National University of San Martin: Tarapoto, PE 2020 to date | Human Medicine Student (San Martin) Education

Cesar Alonso Arpasi Sinti, Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú.

National University of San Martin: Tarapoto, PE 2020 to date | Human Medicine Student (San Martin) Education

Milka Malena Prentice Mori, Department of Internal Medicine, Hospital II-2 Tarapoto, San Martin-Peru

National University of San Martín: Tarapoto, PE Professor of Human Medicine (San Martín) Education Dr. Milka Malena Prentice Mori works at Hospital II-2 Tarapoto Doctor in Neurology
Collegiate Number: CMP 54393 RNE 037130

Master in Health Services Management
Prentice Mori, Milka Malena (ORCID: 0000-0002-3868-5661)

University Professor at the National University of San Martín, assigned to the Academic Department of Human Medicine.

General Studies: Professional Title: Medical Surgeon - Universidad Particular San Martin Porres.

Master's Degree: Health Services Management Cesar Vallejo- Lima.

Doctorate:

Second Specialty (Medical Residency): National University Federico Villarreal Lima.

Status: Contracted.

Teaching Category: Assistant.

Time commitment: Full time.

Professional experience: (5 years) as a University Professor, working as such at the National University of San Martín.

Heriberto Arévalo Ramírez, Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú. / Laboratorio Referencial Regional de Salud Pública de San Martín, Tarapoto, Perú.

Regional Health Directorate San Martín: Moyobamba, San Martin, PE: 2017 | CONGRATULATIONS TO THE FOUNDING STAFF OF THE SAN MARTIN REGIONAL REFERENCE LABORATORY Distinction RINGGOLD Organization Identifiers: 298547 Regional Health Directorate San Martín: Moyobamba, San Martin, PE Other Organization Identifiers Provided by RINGGOLD ISNI: 0000000405886031 Added 2020-09-24 Last Modified 2020-09-24 National University of San Martin Tarapoto: Tarapoto, PE 2015 | Recognition and Congratulations as a Collaborator of the San Martín Regional Health Directorate Distinction RINGGOLD Organization Identifiers: 187077 National University of San Martin Tarapoto: Tarapoto, PE Other organization identifiers provided by RINGGOLD ISNI: 0000000403963777 Added 2020-09-24 Last modified 2020-09-24 National Council of Science and Technology and Technological Innovation: Lima, PE 2022-09-01 until 2024-09-01 | RENACYT Researcher (None Group - Level VI) Qualification RENACYT CODE: P0020532 Show less details RINGGOLD Organization Identifiers: 187058 National Council of Science and Technology and Technological Innovation: Lima, PE Other organization identifiers provided by RINGGOLD ISNI: 0000000121665691 OFR: http://dx.doi.org/10.13039/501100010747 URL http://ctivitae.concytec.gob.pe/appDirectorioCTI/VerDatosInvestigador.do?id_investigador=20532 Added 2022-09-04 Last modified 2022-09-04 University of Chile: Santiago de Chile, CL MASTER IN BIOLOGICAL SCIENCES, WITH MENTION IN PARASITOLOGY Education Show less details Organization Identifiers RINGGOLD: 14655 University of Chile: Santiago de Chile, CL Other organization identifiers provided by RINGGOLD ISNI: 0000000403854466 OFR: http://dx.doi.org/10.13039/501100005853 Added 2020-09-24 Last modified 2020-09-24 National University of Trujillo: Trujillo, La Libertad, PE BIOLOGIST MICROBIOLOGIST Education Show less details Organization Identifiers FUNDREF: http://dx.doi.org/10.13039/501100008443 National University of Trujillo: PE Added 2020-09-24 Last modified 2020-09-24 National University of Trujillo: Trujillo , La Libertad, PE BACHELOR OF BIOLOGICAL SCIENCES Education Show less details Organization identifiers FUNDREF: http://dx.doi.org/10.13039/501100008443 National University of Trujillo: PE Added 2020-09-24 Last modified 2020-09-24

Carlos Javier Mego Silva, Facultad de Medicina Humana, Universidad Nacional de San Martín. Tarapoto, Perú. / Departamento de Cirugía y Especialidades, Servicio de Cirugía, Hospital II-2 Tarapoto. Tarapoto, Perú.

He is a general surgery specialist and serves as director of the Specialized Health Services Management Office (OGESS) at Hospital II-2 Tarapoto. He is a distinguished Peruvian researcher affiliated with the National Registry of Researchers in Science and Technology (RENACYT). He has contributed to the development of scientific research in various areas related to health. He is a graduate of the Universidad Nacional Mayor de San Marcos (UNMSM) and has been recognized on multiple occasions for his academic and scientific work, in addition to collaborating with scientific institutions in Peru. Currently, his focus includes innovative projects in biomedicine and public health, standing out as a key researcher in the region.

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Published

2025-12-19

How to Cite

1.
Arrieta Navarro JC, Acosta Alava N, Apaéstegui Reátegui FE, Arpasi Sinti CA, Prentice Mori MM, Arévalo Ramírez H, et al. Gastric perforation induced by non-steroidal anti-inflammatory drugs: a case report. Rev Méd Hered [Internet]. 2025 Dec. 19 [cited 2025 Dec. 27];36(4):360-6. Available from: https://revistas.upch.edu.pe/index.php/RMH/article/view/6162

Issue

Vol. 36 No. 4 (2025): Octubre-diciembre

Section

CASE REPORTS

License

Copyright (c) 2025 Julio Caleb Arrieta Navarro, Nataly Acosta Alava, Fiorella Ester Apaéstegui Reátegui , Cesar Alonso Arpasi Sinti, Milka Malena Prentice Mori, Heriberto Arévalo Ramírez, Carlos Javier Mego Silva

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