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.

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 Endoscopy Capsule Retention in a Young Female with Small Bowel Strictures Secondary to Non-Steroidal Anti-Inflammatory Drugs

2021 ◽  
pp. 948-953
Author(s):  
Muhammad Umair Tayyub ◽  
Laurence Egan ◽  
Carol Goulding
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Young Female ◽  
Small Bowel Stricture ◽  
Chronic Anaemia ◽  
History Of ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Capsule Retention ◽  
Bowel Stricture

Non-steroidal anti-inflammatory drugs (NSAIDs) can cause small bowel damage, which could present in different ways, including abdominal pain and occult gastrointestinal bleeding. NSAID use can also result in small bowel strictures, which can be challenging to diagnose and manage. Here, we describe a case of a 49-year-old female who presented with chronic anaemia and intermittent abdominal pain, with a history of NSAID use. She underwent capsule endoscopy as part of the workup for anaemia and subsequently had capsule retention due to a small bowel stricture.

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 Idiopathic localised dilatation of the intestine in adults

2019 ◽  
Vol 12 (8) ◽  
pp. e230443
Author(s):  
Niccolò Rotigliano ◽  
Matthias Sauter ◽  
Markus von Flüe ◽  
Daniel Christian Steinemann
Keyword(s):  
Systematic Review ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Small Bowel Obstruction ◽  
Small Bowel Stricture ◽  
Segmental Dilatation ◽  
Bowel Stricture ◽  
Radiological Studies

Idiopathic localised dilatation of the intestine (ILDI) presenting in adults is rare and difficult to diagnose. Only 18 cases have been reported in the literature. We report a case of a 32-year-old woman presenting with abdominal pain and intermittent small bowel obstruction. After detailed radiological studies, the patient, known for Crohn’s disease, was scheduled for laparoscopy in the suspicion of small bowel stricture. A localised dilatation of the ileum was found intraoperatively and subsequently resected. A systematic review of this rare pathology in adults is carried out. ILDI should be part of the differential diagnosis in patients with unexplained abdominal pain or gastrointestinal bleeding in the presence of segmental dilatation of the intestine. Surgical resection is the treatment of choice.

scholarly journals A rare case of idiopathic multiple small bowel strictures in Indian subcontinent: a case report

2021 ◽  
Vol 8 (12) ◽  
pp. 3710
Author(s):  
Garima Dwivedi ◽  
Sanjeev Kumar Singla ◽  
Rohit Virmani
Keyword(s):  
Small Bowel ◽  
Iron Deficiency ◽  
Small Bowel Obstruction ◽  
Iron Deficiency Anemia ◽  
Bowel Obstruction ◽  
Indian Subcontinent ◽  
Deficiency Anemia ◽  
Small Bowel Stricture ◽  
Resection And Anastomosis ◽  
Bowel Stricture

Small bowel ulcers and strictures are uncommon but when they occur they can be an important cause of morbidity. We reported a case of a multiple strictures in small bowel that was treated surgically pain for 15 years. She also had hypoalbuminemia and iron deficiency anemia. A diagnosis of small bowel stricture was made on CT and surgery was advised. Resection of the 100 cm long segment of small bowel was done. Approximately 10 smooth strictures were identified in the resected segment. Histology did not identify any specific cause. A 43 year old Indian female was diagnosed with subacute small bowel obstruction. She had a history of chronic abdominal pain for 15 years. She also had hypoalbuminemia and iron deficiency anemia. A diagnosis of small bowel stricture was made on CT and surgery was advised. Resection of the 100 cm long segment of small bowel was done. Approximately 10 smooth strictures were identified in the resected segment. Histology did not identify any specific cause. Subacute small bowel obstruction can be associated with various factors. Multiple idiopathic small bowel strictures can be considered as one of the causes. In present case no cause of ulcers and strictures could be found. Idiopathic multiple bowel strictures with fecalith is rare. Histopathology and other investigations revealed no specific cause. We recorded no postoperative complications 2 months after surgery by resection and anastomosis. 

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