Ischaemic colitis and ergotamine – A case report
Keywords:
Ischaemic colitis, migraine, ergotamine, drugsAbstract
The A.A. describe the case of a 49-year-old man, previously diagnosed as having migraine
with aura and essential hypertension, who came to the emergency room because he experienced
syncope after suddenly feeling abdominal pain.
In the hospital three episodes of liquid bloody stools were reported. The patient had experienced fronto-occipital headaches during the week prior to admission and had self-medicated with an ergotamine derivate (ergotamine tartarate).
Examination revealed abdominal pain on deep
palpation of the inferior quadrants. A colonoscopy showed oedematous mucosa and scattered erosions distal to the median transverse colon and minimal lesions in the recto-sigmoid
transition. Colon biopsy identified ischaemic colitis. After suspension of enteric nutrition and
supportive care, the patient recovered.
The authors review the possible interactions between ischaemic colitis and drugs, underlying
the rarity of the case. Early diagnosis and notification to the National Pharmacovigilance Centre are extremely important.
Downloads
References
Greenwald D, Brandt L. Colonic ischemia. Clinical Reviews: The Colon, Inflammatory Bowel Disease, And Infectious Diseases 1998;27(2):
-128.
Brandt L. Ischemic lesions of the bowel. In: Gastrointestinal and Liver Disease 6th edition. Feldman M, Scharschmidt B, Sleisenger M (editors). W. B. Saunders Company 1999.
Boley S, Schwartz S, Lash J et al. Reversible vascular occlusion of the colon. Surg Gynecol Obstet 1963;116:53-60.
Rogers D, Mansberger J. Gastrointestinal vascular ischemia caused by ergotamine. Southern Medical Journal 1989;82(8):1058-1059.
Appu S, Thompson G. Gangrenous ischaemic colitis following non-steroidal anti-inflammatory drug overdose. ANZ J Surg 2001;71(11):
-695.
Yarze J. Ischaemic colitis and meloxicam. Lancet 2001;19;357 (9268):1619.
Bechade D, Algayres J, Coutant G, Bili H, Desrame J, Daly J. Segmental non-gangrenous ischemic colitis during a non-steroidal anti-inflammatory treatment. Rev Med Interne 1999; 20(2):184-185.
Garcia B, Ramaholimihaso F, Diebold M, Cadiot G, Thiefin G. Ischaemic colitis in a patient taking meloxicam. Lancet 2001 3;357(9257):
Carratu R, Parisi P, Agozzino A. Segmental ischemic colitis associated with nonsteroidal antiinflammatory drugs. J Clin Gastroenterol
;16(1):31-34.
Klestov A, Kubler P, Meulet J. Recurrent ischaemic colitis associated with pseudoephedrine use. Intern Med J 2001;31(3):195-196.
Lichtenstein G, Yee N. Ischemic colitis associated with decongestant use. Ann Intern med 2000 18;132(8):682.
Schneider R. Ischemic colitis caused by decongestant? J Clin Gastroenterol 1995;21(4):335-336.
Dowd J, Bailey D, Moussa K, Nair S, Doyle R, Culpepper-Morgan J. Ischemic colitis associated with pseudoephedrine: four cases. Am j
Gastroenterol 1999;94(9):2430-2434.
Barouk J, Doubremelle M, Faroux R, Schnee M, Lafargue J. Ischemic colitis after taking flutamide. Gastroenterol Clin Biol 1998;22(10):841.
Frossard J, Spahr L, Queneau P, Armenian B, Brundler M, Hadengue A. Ischemic colitis during pregnancy and contraceptive medication.
Digestion 2001;64(2):125-127.
Deana D, Dean P. Reversible ischemic colitis in young women. Association with oral contraceptive use. Am J Surg Pathol 1995;19(4):454-
Daniele B, Rossi G, Losito S, Gridelli C, De Bellis M. Ischemic colitis associated with paclitaxel. J Clin Gastroenterol 2001;33(2):159-160.
Stillman A, Weinberg M, Mast W, Palpant S. Ischemic bowel disease attributable to ergot. Gastroenterology 1977;72(6):1336-1337.
Peroutka S. Fármacos eficazes no tratamento da enxaqueca. In: As Bases Farmacológicas da terapêutica 9ª edição. Hardman J, Limbird
L, Molinoff P, Ruddon R, Gilman A (editores). McGraw-Hill Interamericana Editores, 1996.
Rutgeerts L, Ghillebert G, Drognee W, Tanghe W, Vuylsteke P et al. Ischemic colitis in a patient with Crohn’s disease taking an oral contraceptive and an ergotamine alkaloid. Acta Clinica Belgica 1993;48:48-51.
Papalampros L, Salakou S, Felekouras E, Scopa C, Tsamandas A, Bastounis E. Ischemic necrosis of gastric wall after long-term ergotamine
pill abuse: case report and review of the literature. Digestive Diseases and Sciences 2001;46(5):981-984.
Enriquez E, Rangel A, Velasco C, Basave M, Lopez-Rodrigues R. Ergotism by automedication. Archivos del Instituto de Cardiologia de
Mexico 2000;70(6):603-608.
Knudsen J, Friedman B, Chen M, Goldwasser J. Ischemic colitis and sumatriptan use. Arch intern med 1998;158(17):1946-1948.
Tada H, Saitoh S, Nakagawa Y, Hirana H, Morimoto M, Shima T. Ischemic colitis during interferon-alpha treatment for chronic active
hepatitis C. J Gastroenterol 1996;31(4):582-584.
Laporte J, Carné X, Vidal X, Moreno V, Juan J. Upper gastrointestinal bleeding in relation to previous use of analgesics and non-steroidal
anti-inflammatory drugs. The Lancet 1991;337:85-89.
Brogden R. Pyrazolone derivatives. Drugs 1986;32(4):60-70.
Nabel E. Genomic medicine: cardiovascular disease. N Engl J Med2003;349(1):60-72.
Bick R, Kaplan H. Syndromes of thrombosis and hypercoagulability: congenital and acquired causes of thrombosis. Med Clin North Am
;82(3):409-448.
Yee N, Guerry D, Lichtenstein G. Ischemic colitis associated with factor V Leiden mutation. Ann Intern Med 2000 Apr 4;132(7):595-596.
Additional Files
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna
Open Access
