title: Duodenal diverticulum complicated by duodenal inflammation and obstruction secondary to the use of the NSAID diclofenac.
abstract: In one patient, upper abdominal symptoms developed 6 months after the start of diclofenac. At upper gastrointestinal endoscopy duodenal stenosis was shown next to a large diverticulum containing non-dissolved tablets in the third part of the duodenum. As there was no improvement with medical treatment, resection of the diverticulum and stenosis with primary end-to-end anastomosis was performed. Apart from persistent activity of rheumatoid arthritis the patient has been well since. The possible gastrointestinal side-effects of nonsteroidal antiinflammatory drugs in patients with duodenal diverticula are discussed.
authors.affiliation: Department of Gastroenterology-Hepatology, University Hospital, Leiden, The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Veenendaal
authors.forename: A J
authors.initials: AJ
authors.lastname: Peeters
authors.forename: J
authors.initials: J
authors.lastname: Kreuning
authors.forename: S
authors.initials: S
authors.lastname: Peña
authors.forename: H G
authors.initials: HG
authors.lastname: Gooszen
authors.forename: C B
authors.initials: CB
authors.lastname: Lamers
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D004008:Diclofenac / Q000009:adverse effects* / Q000627:therapeutic use; D004380:Duodenal Obstruction / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D011859:Radiography
chemical_list: D004008:Diclofenac