Summary
Many reports have mentioned the role of nonsteroidal antiinflammatory drugs in inducing diaphragmlike strictures in the small and large bowel. These lesions are mostly seen in patients with chronic use of nonsteroidal antiinflammatory drugs. We report the case of a 57-year-old man who developed a diaphragmlike stricture in the second part of the duodenum. The patient had been using a preparation containing acetylsalicylic acid during many years. Although a congenital origin of the diaphragm is not completely excluded, we postulate that this stricture probably occurred as a result of acetylsalicylic acid-induced ulcerations, followed by submucosal fibrosis.
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References
Sturges HF, Krone CL: Ulceration and stricture of the jejunum in a patient on long-term indomethacin therapy. Am J Gastroenterol 59:162–169, 1973
Fellows IW, Clarbe JMF, Roberts PF: Non-steroidal antiinflammatory drug-induced jejunal and colonic diaphragm disease: a report of two cases. Gut 33:1424–1426, 1992
Neoptolemos JP, Locke TJ: Recurrent small bowel obstruction associated with phenylbutazone. Br J Surg 70:244–245, 1983
Madhok R, MacKenzie JA, Lee FD, Bruchner FE, Terry TR, Sturrock RD: Small bowel ulceration in patients receiving non-steroidal anti-inflammatory drugs for rheumatoid arthritis. Q J Med 225:53–58, 1986
Bjarnason I, Price AB, Zanelli G, Smethurst P, Burke M, Gumpel JM, Levi AJ: Clinicopathological features of non-steroidal antiinflammatory drug-induced small intestinal strictures. Gastroenterology 94:1070–1074, 1988
Bjarnason I, Fehilly B, Smethurst P, Menzies IS, Levi AJ: Importance of local versus systemic effects of non-steroidal anti-inflammatory drugs in increasing small intestinal permeability in man. Gut 32:275–277, 1991
Huber T, Ruchti C, Halter F: Nonsteroidal antiinflammatory drug-induced colonic stricture: A case report. Gastroenterology 100:1119–1122, 1991
Bilbao MK, Frische LH, Rösch J, Benson JA Jr, Dotter CT: Postbulbar duodenal ulcer and ring-stricture. Radiology 100:27–357, 1971
Veenendaal RA, Peeters AJ, Kreuning J, Pena S, Gooszen HG, Lamers CBHW: Duodenal diverticulum complicated by duodenal inflammation and obstruction secondary to the use of the NSAID diclofenac. Gastroenterol Clin Biol 15:355–357, 1991
Lang J, Price AB, Levi AJ, Burke M, Gumpel JM, Bjanrasson I: Diaphragm disease: Pathology of disease of the small intestine induced by non-steroidal anti-inflammatory drugs. J Clin Pathol 41:516–526, 1988
Bjarnasson I, Peters TJ: Intestinal permeability, non-steroidal anti-inflammatory drug enteropathy and inflammatory bowel disease: An overview. Gut Festschrift 1989:22–28, 1989
Krieg EG: Duodenal diaphragm. Ann Surg 106:33–41, 1937
Nance FC: Intraluminal duodenal diverticula. Surg Gynecol Obstet 125:613–618, 1967
Salonen IS: Congenital duodenal obstruction. Acta Paediatr Scand Suppl 272:1–86, 1978
Boyden EA, Cope JG, Bill AH: Anatomy and embryology of congenital intrinsic obstruction of the duodenum. Am J Surg 114:190–202, 1967
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Blinder, G.H., Hautekeete, M.L., Holvoet, J.P. et al. Duodenal diaphragmlike stricture induced by acetylsalicylic acid. Digest Dis Sci 39, 1365–1369 (1994). https://doi.org/10.1007/BF02093806
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DOI: https://doi.org/10.1007/BF02093806