Non-steroidal anti-inflammatory drug induced intestinal stricturing: diaphragm disease

J Surg Case Rep. 2024 Jan 18;2024(1):rjad489. doi: 10.1093/jscr/rjad489. eCollection 2024 Jan.

Abstract

Diaphragm disease (DD) is a rare small bowel enteropathy associated with non-steroidal anti-inflammatory drug use. Since the first description there have only been approximately 100 cases of DD reported in the literature. Stricturing webs or 'diaphragms' form in the bowel, causing non-specific abdominal symptoms that can ultimately lead to bleeding and obstruction. Diagnosis is notoriously challenging as there is no single gold standard investigation. We present two cases of DD both of which were ultimately diagnosed by surgical resection. We also propose a novel flow algorithm that can be utilized for working up patients with suspected DD.

Keywords: NSAIDs; diaphragm disease; inflammatory bowel disease; stricture.

Publication types

  • Case Reports