Small bowel obstruction and retained pill cam from diaphragmatic strictures associated with non-steroidal anti-inflammatory use: two case studies of this uncommonly reported entity

Pathology ◽  
2019 ◽  
Vol 51 ◽  
pp. S95-S96
Author(s):  
Natasha J. Prosser ◽  
Benjamin M. Allanson ◽  
Christopher J. Young ◽  
Christopher M. Byrne ◽  
Catriona A. McKenzie
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Case Studies ◽  
Bowel Obstruction ◽  
Anti Inflammatory

Diaphragm disease in emergency surgery

2020 ◽  
Vol 81 (3) ◽  
pp. 1-6
Author(s):  
Diwakar R Sarma ◽  
Pratik Bhattacharya
Keyword(s):  
Risk Factors ◽  
Small Intestine ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Emergency Laparotomy ◽  
Diaphragm Disease ◽  
Inflammatory Drugs ◽  
Acute Small Bowel Obstruction ◽  
Anti Inflammatory

Background/Aims Diaphragm disease of the small bowel has been described in the literature over the last three decades. The pathognomonic characteristic of multiple circumferential stenosis is noted on gross examination of the bowel. It is a severe form of non-steroidal anti-inflammatory drug-induced enteropathy, often presenting as acute small bowel obstruction. A systematic review was performed to identify risk factors and patient outcomes in histologically-proven diaphragm disease of the small intestine in patients undergoing emergency operation for small bowel obstruction. Methods A comprehensive search was performed between January 1975 and March 2019 using relevant MeSH terms. Studies were chosen based on predefined inclusion criteria. Diaphragm disease of the small intestine was defined as macroscopically detected thin diaphragm-like mucosal folding inside the lumen of the bowel. The parameters assessed included patient characteristics, duration of use of non-steroidal anti-inflammatory drugs, type of emergency surgery performed, complications, recurrence, presentation and diagnosis of diaphragm disease. Results A total of 21 studies were analysed which included 17 case reports, one case series, and three retrospective comparative studies. Overall 29 patients with diaphragm disease of the small bowel were reported following emergency laparotomy for small bowel obstruction. Use of non-steroidal anti-inflammatory drugs was noted in all cases with an average duration of 3–5 years. All patients presented acutely with features of small bowel obstruction and had emergency laparotomy, except one who underwent laparoscopic resection. In the comparative studies patients were more likely to be female and to have been taking non-steroidal anti-inflammatory drugs for more than 7 years. Conclusions This is a rare disease, difficult to diagnose and often confirmed by the intra-operative macroscopic appearance of circumferential stenosis of the bowel. Risk factors for developing small bowel diaphragm disease include long-term use of non-steroidal anti-inflammatory drugs, and female gender. Patients with this disease are at increased risk of developing acute small bowel obstruction, so early identification is important.

scholarly journals Non-steroidal anti-inflammatory drug-induced diaphragm disease: an uncommon cause of small bowel obstruction

2016 ◽  
Vol 98 (8) ◽  
pp. e189-e191 ◽  
Author(s):  
MME Coolsen ◽  
SJ Leedham ◽  
RJ Guy
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Small Bowel Resection ◽  
Drug Induced ◽  
Inflammatory Drug ◽  
Diaphragm Disease ◽  
Anti Inflammatory ◽  
Diagnostic Work ◽  
Work Up

Surgeons frequently deal with small bowel obstruction. However, small bowel obstruction caused by non-steroidal anti-inflammatory drug (NSAID)-induced diaphragm disease is very rare. The diagnosis is challenging, as symptoms are often non-specific and radiological studies remain inconclusive. We present a case of a 63-year-old man who, after an extensive diagnostic work-up and small bowel resection for obstructive symptoms, was finally diagnosed with NSAID-induced diaphragm disease as confirmed by histology. An unusual aspect of this case is that the patient stopped using NSAIDs after he was diagnosed with a gastric ulcer 2–years previously. This suggests that NSAID-induced diaphragms of the small bowel take some time to develop and underlines the importance of careful history taking.

scholarly journals A CASE OF SMALL BOWEL OBSTRUCTION INDUCED BY NON-STEROIDAL ANTI-INFLAMMATORY DRUG

2008 ◽  
Vol 69 (4) ◽  
pp. 838-840 ◽  
Author(s):  
Katsuhiro KOTAKE ◽  
Hiroshi NAGATA ◽  
Tsuyoshi KUROKAWA ◽  
Masahiko MIYACHI ◽  
Kazuyoshi SUZUMURA ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Inflammatory Drug ◽  
Anti Inflammatory

scholarly journals Diaphragm Disease: NSAID-Induced Small Bowel Stricture

2018 ◽  
Vol 12 (2) ◽  
pp. 327-330 ◽  
Author(s):  
Bruce J. Grattan Jr. ◽  
Tracy Bennett ◽  
Michael R. Starks
Keyword(s):  
Risk Factor ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Small Bowel Stricture ◽  
Diaphragm Disease ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Bowel Stricture

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is ubiquitous. However, it remains an oftentimes under-recognized risk factor for the development of strictures and small bowel obstruction. Herein we describe the case of a 63-year-old female with a prolonged course of abdominal pain and occult anemia found to have a diaphragmatic stricture in the small bowel related to chronic NSAID use.

Nonsteroidal anti-inflammatory induced small bowel obstruction

2002 ◽  
Vol 171 (2) ◽  
pp. 118-118
Author(s):  
R. G. Casey ◽  
M. Tan ◽  
J. Ryan ◽  
P. Gillen
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Anti Inflammatory

scholarly journals An uncommon case of partial small‐bowel obstruction: Non‐steroidal anti‐inflammatory drug enteropathy

2014 ◽  
Vol 21 (4) ◽  
pp. 165-166
Author(s):  
Miguel Serrano ◽  
Susana Mão de Ferro ◽  
Sara Ferreira ◽  
Paula Chaves ◽  
António Dias Pereira
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Inflammatory Drug ◽  
Partial Small Bowel Obstruction ◽  
Uncommon Case ◽  
Anti Inflammatory
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