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Duodenal Perforation After Ibuprofen Overdose

Poisoning with aspirin and other non-steroidal antiinflammatory drugs (NSAID) is common, and these agents are used in 21% of overdoses in the Northwest of England (data from Manchester and Salford SelfHarm Group). Ibuprofen was the commonest pharmaceutical enquiry in American Association of Poisons Control Centers Toxic Exposure Surveillance System during 2003, with 71,043 enquiries (5.3% of all pharmaceutical enquiries) (1). Although the gastrointestinal side-effects of chronic NSAID use, in particular gastric and duodenal ulceration, are well-documented, they are a less significant feature of acute toxicity (2,3); there has only been one previous report of perforated peptic ulceration associated with a mixed mefenamic acid and aspirin overdose (4) and this case had other potential confounding factors. A case of perforated duodenal ulcer following acute overdose of ibuprofen in a patient with no other identified risk factors is described. CASE REPORT