Case Reports in Gastroenterology (Jun 2018)

A Small Bowel Ulcer due to Clopidogrel with Cytomegalovirus Enteritis Diagnosed by Capsule and Double-Balloon Endoscopy

  • Masahide Ebi,
  • Satoshi Inoue,
  • Tomoya Sugiyama,
  • Kazuhiro Yamamoto,
  • Kazunori Adachi,
  • Takashi Yoshimine,
  • Yoshiharu Yamaguchi,
  • Yasuhiro Tamura,
  • Shinya Izawa,
  • Yasutaka Hijikata,
  • Yasushi Funaki,
  • Naotaka Ogasawara,
  • Makoto Sasaki,
  • Kunio Kasugai

DOI
https://doi.org/10.1159/000490096
Journal volume & issue
Vol. 12, no. 2
pp. 303 – 310

Abstract

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We report the first case of small bowel ulcers due to clopidogrel in a 74-year-old man. He presented with diarrhea and melena after having been taking low-dose aspirin (LDA) and clopidogrel. There was no evidence of bleeding in the stomach, duodenum, or colon. Capsule endoscopy showed multiple ulcers and erosions in the small intestine. Double-balloon endoscopy revealed multiple ulcers throughout the ileum. Examination of the biopsy specimen showed cytomegalovirus infection. His LDA was discontinued and he was prescribed ganciclovir. However, the small bowel ulcers were aggravated. Therefore, clopidogrel was discontinued. The small bowel ulcers subsequently healed completely, forming scars.

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