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Diaphragm disease compared with cryptogenic multifocal ulcerous stenosing enteritis.
Sook Hee Chung1, Yunju Jo, Sang Ryol Ryu
1Department of Internal Medicine, Eulji University School of Medicine, Seoul 139-711, South Korea.
World Journal of Gastroenterology
|July 8, 2011
Summary
Nonsteroidal anti-inflammatory drug (NSAID) enteropathy can cause severe gastrointestinal issues. This case highlights diaphragm disease, a rare complication of NSAID use, diagnosed via capsule endoscopy.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pharmacology
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, leading to increased gastrointestinal complications.
- NSAID enteropathy, a severe form of intestinal damage, can manifest as chronic ulceration, fibrosis, and strictures.
- Diaphragm disease is the most advanced stage of NSAID enteropathy, characterized by submucosal fibrosis and muscularis destruction.
Observation:
- A rare case of diaphragm disease caused by NSAID use is presented.
- The patient presented with chronic obscure gastrointestinal bleeding.
- Capsule endoscopy revealed multiple ulcers and strictures in the small intestine, leading to the diagnosis.
Findings:
- The gross findings of diaphragm disease can mimic cryptogenic multifocal ulcerous stenosing enteritis (CMUSE).
- Capsule endoscopy was crucial in differentiating diaphragm disease from CMUSE in this case.
- The patient was diagnosed with diaphragm disease after surgical intervention.
Implications:
- This case underscores the importance of considering NSAID enteropathy in patients with obscure gastrointestinal bleeding and small intestinal strictures.
- Capsule endoscopy is a valuable tool for diagnosing diaphragm disease and identifying the source of bleeding.
- Early recognition and diagnosis of NSAID-induced diaphragm disease are critical for appropriate management and to prevent severe complications.
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