Oesophageal ulceration in adult patients treated with doxycycline for acne vulgaris

Objective To report drug-induced oesophageal ulceration in adult patients treated with doxycycline for acne vulgaris. Methods This retrospective case series included data from adult patients treated with oral doxycycline therapy for acne vulgaris, who had presented with oesophageal ulceration at the Third People’s Hospital of Hangzhou between June 2016 and December 2017, and whose diagnosis was confirmed by gastroscopy. Clinicodemographic data were analysed, including symptom onset, endoscopy results, that were assessed for classic features of oesophageal ulceration. Patients were questioned regarding medication intake. Results A total of 12 patients were included (mean age, 23.50 ± 3.20 years), eight (66.67%) of whom were female. Based on history of medication and endoscopic findings, these patients were diagnosed with doxycycline-induced oesophageal ulceration. Most patients were found to have taken the medication at bedtime, just before lying down, and/or with insufficient water. Conclusion Doxycycline may cause oesophageal irritation when not taken with sufficient water, or taken just before lying down to sleep. Prescribing physicians should be aware of these issues, and instruct patients as to the correct method for intake of doxycycline.

Gastrointestinal therapy techniques

Insertion of a Sengstaken–Blakemore tube in critical care 74Upper gastrointestinal endoscopy 76Nasojejunal feeding in critical care patients 78The Sengstaken–Blakemore tube is very effective at controlling torrential bleeding from oesophago-gastric varices. Its use is associated with serious complications such as oesophageal ulceration, oesophageal perforation and aspiration pneumonia in 15–20% of cases. Up to 50% of patients will re-bleed once the balloon is deflated. so its primary function is to control bleeding initially prior to further definitive treatment....

Accidental Ingestion of Steradent Tablets in a Patient with Cognitive Impairment

Accidental ingestion of medicines and household goods can be a problem in people with cognitive impairment. There is significant associated morbidity and mortality. Here we present a case of an 87-year-old gentleman with vascular dementia who accidentally ingested two Steradent denture-cleaning tablets. He rapidly developed acute upper airway obstruction and extensive oesophageal ulceration. He required intubation and ventilation. This case reinforces the importance of minimising the risk of accidental ingestion.

Pathomorphological study on gastroduodenal ulceration in horses: Localisation of lesions

Gastroduodenal ulceration is a prevalent disease in foals and adult horses. Decreased performance as well as fatal complications relate to this syndrome. The objective of our study was to determine the prevalence of gastric ulceration in a mixed population of horses by postmortem examination and to evaluate a possible association between equine gastric ulcer syndrome (EGUS) and sex or age of the examined horses, to evaluate the localisation of lesions in the proximal part of the gastrointestinal tract and to determine the occurrence of gastric parasites. Post-mortem examinations were performed on 71 horses over a period of 24 months. Gastric ulcers were found in 52 horses (73.2%). There was no significant association between age or sex and occurrence of gastric ulcers. In all horses the squamous mucosa lesions were localised near the margo plicatus (100% of the cases), whereas in 23 horses the lesions were near the margo plicatus and lesser curvature and in 7 horses at the greater curvature. In 18 horses the mucosa was affected in the whole extent of the margo plicatus and in 1 horse diffuse lesions of the squamous mucosa were noted. Lesions of the glandular mucosa were localised in 11 horses at the fundic area, in 1 horse they occurred in the pylorus, and in 10 horses diffuse lesions of the glandular mucosa were recorded. A low prevalence of Gasterophilus intestinalis infection was detected (1 horse, 1.4%). We have confirmed that gastric ulcers are a common problem in horses and duodenal or oesophageal ulceration is rare (not a single case of the latter was found in this study). Lesions in the glandular mucosa of the stomach are more frequent in suckling foals than in older animals. Lesions of the glandular mucosa are also common in adult horses, and a complete gastroscopic examination including examination of the pylorus is advisable to evaluate this syndrome.