Nonsteroidal anti-inflammatory drugs induced diaphragm disease: a report of 3 cases and literature review

Abstract

Multiple strictures of small bowel induced by nonsteroidal anti-inflammatory drugs (NSAIDs), were known as diaphragm disease. The purpose of these case reports is to present 3 cases of diaphragm disease of small bowel and summarize the clinical features of this disease entity. A 34-year-old man, a 63-year-old man, and a 66-year-old woman were admitted to Daegu Catholic University Medical Center because of recurrent intestinal obstructions. Two of these patients had taken heavy NSAIDs use. Capsule endoscopy was performed in all cases and the all capsules were retained by circumferential strictures of the ileum. Segmental resection of the strictures was performed in 2 patients and 1 underwent just enterotomy and capsule removal. In conclusion, clinicians should be aware that diaphragm disease might be a cause of small bowel obstruction especially in patients receiving long term NSAIDs therapy.

Diagnosis of Small Intestinal Diaphragms and Strictures Induced by Non-steroidal Anti-inflammatory Drugs Through Intraoperative Enteroscopy: A Case Study From Saudi Arabia

“…She was diagnosed with capsule endoscopy and managed by strict plastic surgery [ 11 ]. Another report of three cases who were diagnosed with NSAID-induced diaphragm disease showed that the capsule endoscopy showed circumferential strictures of the ileum, which were managed by segmental resection and enterotomy [ 12 ]. Another case of a 60-year-old Irish male was diagnosed with multiple intestinal diaphragms unmasked with severe duodenal ulcers that resulted from long-term exposure to 5-aminosalicylic acid (5-ASA) and immune suppression and was investigated by abdominal endoscopy and CT scanning [ 13 ].…”