Opioid kullanýmý ile iliþkili duodenal perforasyon

Özet

Yoðun opioid kullanýmý miyokardiyal enfarktüs, iskemik inme ve gastrointestinal sistemin hipoperfüzyonu gibi bazý vasküler patolojilere sebep olur. Burada, bilinen herhangi bir iskemik veya gastrointestinal hastalýk öyküsü olmayan 30 yaþýnda bir erkek hastanýn 10 yýllýk yoðun opioid kullanýmý sonrasý meydana gelen duedonal perforasyon vakasýný sunduk. Opioidlere uzun süre maruz kalýnmasý hipersensitivite reaksiyonlarýna, iskemi ve hipoperfüzyona neden olabilir. Ayrýca buna opioid ile iliþkili gastrointestinal motilite bozukluklarýnýn eklenmesi de epitel hasarýna ve perforasyona katkýda bulunabilir. Yoðun eroin kullanan kiþilerde gastrointestinal semptomlarýn varlýðýnda iskemik olaylarýn varlýðý akýlda tutulmalýdýr

Abstract

A number of vascular pathologies are attributed to the opiate exposure such as myocardial infarction, ischaemic stroke, and hypoperfusion of the gastrointestinal tract. Here we presented a 30-year-old male patient with no history of any ischemic or gastrointestinal disease known to have 10-year opioid use and had suffered a duodenal perforation. Prolonged exposure of opioids may lead to hypersensitivity reactions, ischemia and hypoperfusion and combination of these entities with opioid-related gastrointestinal motility deficits could contribute to the epithelial damage and perforation as a consequence. The presence of ischemic events should be kept in mind in the presence of gastrointestinal symptoms in people using intensive heroin.