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Small-bowel diaphragm disease: seven surgical cases
Michael E Kelly1, Lisa E McMahon, Dawn E Jaroszewski
1Division of General Surgery, Mayo Clinic, Scottsdale, Ariz 85259, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|December 21, 2005
Summary
Nonsteroidal anti-inflammatory drugs can cause small-bowel diaphragm disease, leading to bleeding and obstruction. Diagnosis is challenging and often requires surgery for small-bowel resection.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Small-bowel diaphragm disease is a rare but serious condition.
- It can cause significant gastrointestinal bleeding and obstruction.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are implicated in its development.
Purpose of the Study:
- To investigate the clinical presentation and management of small-bowel diaphragm disease.
- To highlight the association between NSAID use and this condition.
- To emphasize diagnostic challenges and surgical necessity.
Main Methods:
- A case series of seven patients with histologically confirmed NSAID-induced enteropathy.
- Evaluation of symptoms, diagnostic workup, medication history, and surgical findings.
- Interventions included laparotomy with small-bowel resection.
Main Results:
- All seven patients presented with subacute intestinal obstruction or gastrointestinal bleeding.
- Extensive non-diagnostic radiologic and endoscopic examinations were performed.
- Diagnosis was confirmed by video capsule endoscopy or laparotomy, revealing diaphragms requiring resection.
Conclusions:
- NSAIDs are strongly linked to diaphragm disease in the gastrointestinal tract.
- Small-bowel diaphragm disease may be underdiagnosed and presents with bleeding or obstruction.
- Difficult diagnosis often necessitates surgical intervention, including small-bowel resection.
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