title: Non-steroidal anti-inflammatory drug-induced diaphragm disease: an uncommon cause of small bowel obstruction.
abstract: 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.
authors: Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals , UK.|Department of Surgery, University Hospital Maastricht , Maastricht , The Netherlands.
authors: Mme
authors: M
authors: Coolsen
authors: Gastrointestinal Stem Cell Biology Laboratory, Wellcome Trust Centre for Human Genetics, University of Oxford , UK.|Translational Gastroenterology Unit, John Radcliffe Hospital , Oxford , UK.
authors: S J
authors: SJ
authors: Leedham
authors: Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals , UK.
authors: R J
authors: RJ
authors: Guy
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D053704:Capsule Endoscopy; D003964:Diaphragm / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects*; D007077:Ileal Diseases / Q000139:chemically induced*; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen
keywords: Abdominal pain; Capsule endoscopy; Intestinal obstruction; NSAID