Recurrence of an NSAID-induced diaphragmatic disease of the small intestine

A 74-year-old woman was referred to the surgical team from clinic, reporting of a 1-week history of vomiting and abdominal distension on a background of previous large bowel resection for a flare up of diverticulitis with a suspicion of diaphragm disease of the small intestine diagnosed at the same time. She was initially managed conservatively owing to the likely diagnosis of adhesion(s) leading to small bowel obstruction, but a CT of the abdomen a day later revealed a recurrence of diaphragmatic disease of the small bowel causing an obstruction, most likely due to chronic non-steroidal anti-inflammatory drug use. She was taken to theatre for an emergency laparotomy and small bowel resection due to previous resections, from which she made a good recovery; she was discharged from hospital 8 days later.