Duodenal diverticulum complicated by duodenal inflammation and obstruction secondary to the use of the NSAID diclofenac.
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.
Veenendaal
R A
RA
Department of Gastroenterology-Hepatology, University Hospital, Leiden, The Netherlands.
Peeters
A J
AJ
Kreuning
J
J
Peña
S
S
Gooszen
H G
HG
Lamers
C B
CB
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
D004008:Diclofenac