Nonsteroidal anti-inflammatory drug-induced diaphragm disease arising in a bypassed ileal segment

The formation of mucosal ileal diaphragms has been previously reported in patients receiving nonsteroidal anti-inflammatory drugs over extended periods of time. Whether this effect is the result of a local or systemic action by the medication has remained unknown. We report the first known instance of diaphragm disease arising in a segment of ileum that had been bypassed for many years and therefore was not exposed normally to luminal contact with the drug. This case supports at least a partial systemic mechanism in the production of the lesion.