scholarly journals CT enteroclysis/enterography findings in drug-induced small-bowel damage

2014 ◽  
Vol 87 (1044) ◽  
pp. 20140367 ◽  
Author(s):  
T Kishi ◽  
K Shimizu ◽  
S Hashimoto ◽  
H Onoda ◽  
Y Washida ◽  
...  
Keyword(s):  
Small Bowel ◽  
Drug Induced ◽  
Ct Enteroclysis

scholarly journals Current knowledge on non-steroidal anti-inflammatory drug-induced small-bowel damage: a comprehensive review

2019 ◽  
Vol 55 (5) ◽  
pp. 481-495 ◽  
Author(s):  
Toshio Watanabe ◽  
Yasuhiro Fujiwara ◽  
Francis K. L. Chan
Keyword(s):  
Small Bowel ◽  
Current Knowledge ◽  
Significant Proportion ◽  
Intestinal Barrier ◽  
Intestinal Barrier Function ◽  
Drug Induced ◽  
Anti Inflammatory ◽  
Factor Α ◽  
Small Bowel Endoscopy ◽  
Intestinal Ulcers

AbstractRecent advances in small-bowel endoscopy such as capsule endoscopy have shown that non-steroidal anti-inflammatory drugs (NSAIDs) frequently damage the small intestine, with the prevalence rate of mucosal breaks of around 50% in chronic users. A significant proportion of patients with NSAIDs-induced enteropathy are asymptomatic, but some patients develop symptomatic or complicated ulcers that need therapeutic intervention. Both inhibition of prostaglandins due to the inhibition of cyclooxygenases and mitochondrial dysfunction secondary to the topical effect of NSAIDs play a crucial role in the early process of injury. As a result, the intestinal barrier function is impaired, which allows enterobacteria to invade the mucosa. Gram-negative bacteria and endogenous molecules coordinate to trigger inflammatory cascades via Toll-like receptor 4 to induce excessive expression of cytokines such as tumor necrosis factor-α and to activate NLRP3 inflammasome, a multiprotein complex that processes pro-interleukin-1β into its mature form. Finally, neutrophils accumulate in the mucosa, resulting in intestinal ulceration. Currently, misoprostol is the only drug that has a proven beneficial effect on bleeding small intestinal ulcers induced by NSAIDs or low-dose aspirin, but its protection is insufficient. Therefore, the efficacy of the combination of misoprostol with other drugs, especially those targeting the innate immune system, should be assessed in the next step.

Possible Small-Bowel Neoplasms: Contrast-enhanced and Water-enhanced Multidetector CT Enteroclysis

Radiology ◽  
2006 ◽  
Vol 241 (3) ◽  
pp. 796-801 ◽  
Author(s):  
Frank Pilleul ◽  
Marianne Penigaud ◽  
Laurent Milot ◽  
Jean-Christophe Saurin ◽  
Jean-Alain Chayvialle ◽  
...  
Keyword(s):  
Small Bowel ◽  
Multidetector Ct ◽  
Ct Enteroclysis ◽  
Contrast Enhanced ◽  
Small Bowel Neoplasms

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.

Sign in / Sign up

Export Citation Format

Share Document