Giant Gastric Antral Ulcer Developing After Short-Term NSAID Administration

A 61-year-old man took loxoprofen sodium hydrate, a prodrug NSAID, for acute upper respiratory infection for 5 days, developed melena 2 days later, and was admitted to our hospital. Upper gastrointestinal endoscopy revealed a giant and deeply undermined ulcer mainly in the greater curvature of the antrum, which occupied halfway around the lumen. His medical history was unremarkable. He was negative for Helicobacter pylori infection, and was diagnosed with NSAID-induced acute gastric ulcer in the absence of other causes of gastric ulcer. Giant gastric ulcers, as in this patient, are rare. Moreover, deeply undermined or huge gastric ulcers sometimes develop during the long-term administration of NSAIDs, but very rarely after their short-term administration, which prompted us to report this case.