Unusual Case of Acute Intestinal Obstruction

Abstract

Chronic NSAID use can cause diaphragm like strictures within the bowel leading to intestinal obstruction. This rare entity is called diaphragm disease. Preoperative diagnosis is extremely difficult. NSAID related injury should be considered in patient with intestinal obstruction of unclear etiology. We hereby present an interesting case of a 46 years old lady with significant history of long term naproxen use, who presented with nausea, vomiting and abdominal pain. She was diagnosed with acute intestinal obstruction. She received a trial of conservative management which was unsuccessful. Exploratory laparotomy with segmental resection of ileum was done subsequently. Histopathology showed mucosal ulceration, inflammation and focal sub mucosal fibrosis consistent with diaphragm disease. Patient recovered well in the post operative period.




doi:10.4021/jocmr439w