Oral infections and gastric perforation peritonitis: What is the link?

Abstract

Introduction: The association of gastric perforation peritonitis with an oral infection is rarely reported in the literature. This work reports two cases of gastric perforation peritonitis associated with facial cellulitis or mandibular osteitis in order to analyze the causal link between these two pathological entities. Observations: Two patients, one 25 years old, the other 40 years old, were admitted to the surgical emergency room for epigastric pain with vomiting and cessation of matter and gas. Both patients had been taking nonsteroidal anti-inflammatory drugs for the treatment of dental pain. The clinical investigations concluded to a peritonitis by perforation of a peptic ulcer associated with a parotido-masseterine cellulitis in the first patient and with a mandibular osteitis in the second patient. A laparotomy coupled with antibiotic therapy was performed in both patients. Drainage of the facial collection was performed in the first patient. Treatment of the oral infection entry point was performed in both patients. The evolution was favorable in both patients. Conclusion: The use of anti-inflammatory drugs in the treatment of dental pain without precaution plays a determining role in this association. This work calls for an awareness for a change of behavior in the management of NSAIDs.

Keywords

• Cellulitis
• Dental pain
• Anti-inflammatory drugs
• Peritonitis