1. Department of Nursing, School of Medicine, Shihezi University, Shihezi 832002, China 2. Department of Pediatric Surgery, The Affiliated Northwest Women’s and Children’s Hospital, Xi’an Jiaotong University, Xi’an 710003, China 3. Third Department of General Surgery, The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832002, China 4. Department of Medical Administration, The First Affiliated Hospital, Shihezi University, Shihezi 832002, China 5. Department of Emergency, The First Affiliated Hospital, Shihezi University, Shihezi 832002, China
We report here the rare case of a 61-year-old man with multiple organ dysfunction caused by an aspirin overdose (4 g orally). The patient presented with a fever that reached 39.2 °C, a peptic ulcer, and massive upper gastrointestinal bleeding. His blood test results were as follows: white blood cell count, 1.8×109/L; absolute lymphocytes, 0.4×109/L; absolute neutrophils, 1.2×109/L; and electrolyte disturbances. A computed tomography (CT) scan showed evidence of bilateral inferior pulmonary infection and acute pancreatitis. Thick dark bile with visible floccule was drawn via a percutaneous transhepatic cholangiodrainage (PTCD). Klebsiella pneumoniae was detected in microbiological bile tests. Two years later, the patient died of chronic liver failure.
García Rodríguez LA, Lin KJ, Hernández-Díaz S, Johansson S. Risk of upper gastrointestinal bleeding with low-dose acetylsalicylic acid alone and in combination with clopidogrel and other medications. Circulation 2011; 123(10): 1108–1115
https://doi.org/10.1161/CIRCULATIONAHA.110.973008
pmid: 21357821
Fored CM, Ejerblad E, Lindblad P, Fryzek JP, Dickman PW, Signorello LB, Lipworth L, Elinder CG, Blot WJ, McLaughlin JK, Zack MM, Nyrén O. Acetaminophen, aspirin, and chronic renal failure. N Engl J Med 2001; 345(25): 1801–1808
https://doi.org/10.1056/NEJMoa010323
pmid: 11752356
4
Evans M, Fored CM, Bellocco R, Fitzmaurice G, Fryzek JP, McLaughlin JK, Nyrén O, Elinder CG. Acetaminophen, aspirin and progression of advanced chronic kidney disease. Nephrol Dial Transplant 2009; 24(6): 1908–1918
https://doi.org/10.1093/ndt/gfn745
pmid: 19155536
5
Petersen HHH, Skovbjerg H. Acute pancreatitis—induced by 5-aminosalicylic acid or an extraintestinal manifestation of ulcerative colitis? Ugeskr Laeger 1995; 157(39): 5400–5401 (in Danish)
pmid: 7483055
6
Akyazi I, Eraslan E, Gül?ubuk A, Ekiz EE, C?rakli ZL, Haktanir D, Bala DA, Ozkurt M, Matur E, Ozcan M. Long-term aspirin pretreatment in the prevention of cerulein-induced acute pancreatitis in rats. World J Gastroenterol 2013; 19(19): 2894–2903
https://doi.org/10.3748/wjg.v19.i19.2894
pmid: 23704822
7
Antonopoulos S, Mikros S, Kokkoris S, Protopsaltis J, Filioti K, Karamanolis D, Giannoulis G. A case of acute pancreatitis possibly associated with combined salicylate and simvastatin treatment. JOP 2005; 6(3): 264–268
pmid: 15883478
8
Hagiwara S, Kaneko M, Murata M, Ikegami T, Oshima K. A survival case of severe liver failure caused by acetylsalicylic acid that was treated with living donor liver transplantation. Hippokratia 2014; 18<?Pub Caret?>(1): 71–73
pmid: 25125957