Nimesulide can cause acute hepatitis complicated with peptic ulcer hemorrhage 1 cases.doc

 PAGE \* MERGEFORMAT 7 Nimesulide can cause acute hepatitis complicated with peptic ulcer hemorrhage 1 cases [Keywords:] nimesulide; drug-induced hepatitis; peptic ulcer bleeding Patients, female, 59 years old. Half months ago, no obvious incentive to mild abdominal distention for the intermittent, postprandial increase, accompanied by mild abdominal pain, no nausea, vomiting, hematemesis, melena, etc., and there Niaohuang. Bloating is not serious, were not attention. 4 ~ 5 d after Niaohuang reduce. 2 d before there will be a second black, 1 d before the black again, then two times, and the emergence of two times hematemesis. Post-treatment check stool occult blood, given in upper gastrointestinal bleeding, acid suppression granted, rehydration treatment such as hematemesis, melena symptoms disappeared. Check liver function abnormalities (see Table 1), subsequently admitted to hospital. No ‘hepatitis, peptic ulcer’ medical history, no food, drug allergy history, no history of blood transfusion, the recent history of non-contaminated diet. Admission examination: sclera mild yellow dye, no rash, bleeding points, no liver palms, spider angioma. Cardiopulmonary checkup negative. Abdomen flat, no abdominal varicose veins, abdomen soft, no tenderness rebound tenderness, liver and spleen less than ribs, liver, spleen without percussion pain. Admission diagnosis: (1) upper gastrointestinal bleeding; (2) liver damage of unknown origin. Search gastroscopy after admission: duodenal ulcer, A2 phase, HP-positive; B Ultra: liver size, shape normal, capsule integrity, smooth, the liver shows multiple cysts, the remaining liver parenchyma echo uniform, intrahepatic vascular Traveling Naturally, portal vein diameter of normal; blood count: WBC 10.7 * 109 / L, neutrophils 0.48, lymphocytes 0.46, eosinophils 0.21 * 109 / L, RBC 3.21 * 1012 / L, hemoglobin 103 g / L , platelets 297 * 109 / L; Liver Function: Table 1; coagulation function was normal; Hepatitis Immunization: He