scholarly journals Diaphragm Disease of the Small Bowel Presenting With Intussusception

Cureus ◽  
2021 ◽  
Author(s):  
Vanessa E Al-Feghali ◽  
Kevin Sigley ◽  
Raymond Laird
Keyword(s):  
Small Bowel ◽  
Diaphragm Disease

scholarly journals A rare cause of small bowel diaphragm disease presenting with palpated abdominal mass

2019 ◽  
Vol 2019 (8) ◽  
Author(s):  
Aghyad K Danial ◽  
Ahmad Al-Mouakeh ◽  
Yaman K Danial ◽  
Ahmad A Nawlo ◽  
Ahmad Khalil ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Medical History ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Past Medical History ◽  
Abdominal Symptoms ◽  
Diaphragm Disease ◽  
History Of ◽  
Specific Symptoms

Abstract Small bowel diaphragm disease is a rare complication related to non-steroidal anti-inflammatory drug (NSAID) use. It presents with non-specific symptoms such as vomiting, abdominal pain, subacute bowel obstruction and occasionally as an acute abdominal condition. We report a case of diaphragm disease in a 33-year-old female who presented with vomiting, constipation and abdominal pain started 5 days earlier. Physical examination revealed palpated abdominal mass. The patient’s past medical history was remarkable for NSAID use. The patient was managed by surgical resection of involved intestine and diagnosis was confirmed by histological examination. Although there are few published cases of diaphragm disease in the medical literature, we recommend that this disease should be considered as one of the differential diagnoses when assessing patients presenting with non-specific abdominal symptoms with remarkable past medical history of 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.

Diaphragm Disease of the Small Bowel: A Retrospective Review of CT Findings

2014 ◽  
Vol 202 (2) ◽  
pp. W140-W145 ◽  
Author(s):  
Kristina T. Flicek ◽  
Amy K. Hara ◽  
Giovanni De Petris ◽  
Shabana F. Pasha ◽  
Anitha D. Yadav ◽  
...  
Keyword(s):  
Small Bowel ◽  
Retrospective Review ◽  
Ct Findings ◽  
Diaphragm Disease

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.

Diaphragm Disease of the Small Bowel

2001 ◽  
Vol 32 (4) ◽  
pp. 344-346 ◽  
Author(s):  
Santos Santolaria ◽  
Roger Cabezali ◽  
Javier Ortego ◽  
Tomas Castiella ◽  
Jose C. Salinas ◽  
...  
Keyword(s):  
Small Bowel ◽  
Diaphragm Disease

Extensive NSAID-Induced Small Bowel ‘Diaphragm Disease’

2019 ◽  
Vol 24 (3) ◽  
pp. 704-706
Author(s):  
Brendan James Desmond ◽  
Michael Strettell ◽  
John Keating
Keyword(s):  
Small Bowel ◽  
Diaphragm Disease

scholarly journals Retained enteroscopy capsule in a patient with diaphragm disease

2016 ◽  
Vol 98 (5) ◽  
pp. e79-e81 ◽  
Author(s):  
A-WN Meshikhes
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Bowel Resection ◽  
Diagnostic Modality ◽  
Colicky Abdominal Pain ◽  
Diaphragm Disease ◽  
Inflammatory Drugs ◽  
Subacute Intestinal Obstruction ◽  
High Index Of Suspicion

Introduction Diaphragm disease is a rare consequence of small-bowel enteropathy, and usually occurs as a result of longstanding ingestion of non-steroidal anti-inflammatory drugs. DD is characterized by multiple strictures and saccular dilatations leading to symptoms of subacute intestinal obstruction. Often, the diagnosis is made on histological examination after laparotomy and resection of diseased small bowel. Case History Here, we report a case of an elderly female who suffered for many years from chronic, colicky abdominal pain and anaemia due to undiagnosed diaphragm disease. Eventually, she was referred to our surgical team because of a retained enteroscopy capsule. The diagnosis was made after laparotomy and bowel resection. This surgical intervention alleviated chronic symptoms, and the patient remained well at 1-year follow-up. Conclusions This case highlights the difficulty of diagnosing diaphragm disease without laparotomy and bowel resection. A high index of suspicion must be exercised in any patient with chronic, colicky abdominal pain and anaemia together with multiple strictures and saccular dilatations on computed tomography even in the absence of longstanding NSAID ingestion. Moreover, capsule enteroscopy should be avoided as a diagnostic modality of small-bowel disease if computed tomography raises the suspicion of strictures.

Capsule retention in a patient with eosinophilic gastroenteritis mimicking diaphragm disease of the small bowel

Endoscopy ◽  
2009 ◽  
Vol 41 (S 02) ◽  
pp. E290-E291 ◽  
Author(s):  
S. Pasha ◽  
J. Leighton ◽  
J. Williams ◽  
G. De Petris ◽  
K. Harold ◽  
...  
Keyword(s):  
Small Bowel ◽  
Eosinophilic Gastroenteritis ◽  
Diaphragm Disease ◽  
Capsule Retention
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