Small bowel diaphragm disease from long-term non-steroidal anti-inflammatory use. Issue 10 (5th October 2019)

• Record Type: Journal Article
• Authors: Pereira, Ryan; Slater, Kellee
• Is Part Of: BMJ case reports. Volume 12:Issue 10(2019)
• Publication Date: 2019-10-05
• Subjects: Gastrointestinal surgery -- General surgery -- Small intestine; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-230735
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Small bowel diaphragm disease (SBDD) is characterised by circumferential lesions of short length (<5 mm), causing intrinsic stenosis of the small bowel lumen. A 63-year-old women with a history of long-term non-steroidal anti-inflammatory use, presented with a 12-month history of intermittent episodes of colicky abdominal pain, nausea and vomiting. Her only past surgery was a laparoscopic hysterectomy. Abdominal CT demonstrated an area of thickening in the mid small bowel, however a diagnostic laparoscopy failed to demonstrate adhesions or any external abnormality. A capsule endoscope did not progress beyond the mid small bowel at the site of a suspected diaphragm. The patient underwent a laparotomy and using the retained capsule as a marker, the area of bowel affected by SBDD was identified. With an ageing population and the widespread use of non-steroidalanti-inflammatory drugs, general surgeons may see an increase in the incidence of SBDD.