Nonsteroidal anti-inflammatory drug-induced small bowel strictures (diaphragm disease) - an under-recognized cause of small bowel obstruction
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View abstract on PubMed
Summary
This summary is machine-generated.Nonsteroidal anti-inflammatory drug (NSAID) use can cause small bowel diaphragm disease, leading to obstruction. Preoperative CT enterography may detect strictures but cannot definitively rule out this NSAID-induced condition.
Area Of Science
- Gastroenterology
- Radiology
- Gastrointestinal Surgery
Background
- Small bowel obstruction is a significant cause of morbidity and mortality.
- Recurrent small bowel obstruction can result from circumferential strictures, termed small bowel diaphragm disease.
- This condition is often under-recognized and linked to long-term nonsteroidal anti-inflammatory drug (NSAID) use.
Purpose Of The Study
- To evaluate the sensitivity of preoperative computed tomography (CT) enterography in diagnosing small bowel diaphragm disease.
- To highlight NSAID-induced small bowel injury as an under-recognized cause of obstruction.
Main Methods
- Retrospective review of adult patients undergoing elective small bowel resection for obstruction (2010-2023).
- Analysis of patient history, radiographic, endoscopic, operative, and pathology reports for NSAID use and strictures.
- Exclusion of patients with prior radiation, inflammatory bowel disease, malignancy, adhesive disease, or anastomotic strictures.
Main Results
- 22 patients (10%) met inclusion criteria, all with confirmed NSAID use and histopathologic evidence of stricture.
- Preoperative CT or MR enterography was performed in 82% of patients, detecting stricturing in 72%.
- Intraoperative palpation confirmed strictures in 100% of patients.
Conclusions
- NSAID-induced small bowel injury can manifest as small bowel obstruction.
- Surgeons should consider diaphragm disease in patients with obstruction and NSAID history.
- Preoperative CT or MR enterography can be useful but may not rule out the disease.
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