DIAPHRAGM-LIKE STRICTURES OF THE COLON - A SERIOUS SIDE-EFFECT OF NONSTEROIDAL ANTIINFLAMMATORY DRUGS (NSAID)

While the small-bowel side effects of non-steroidal antiinflammatory d rugs are well-known, NSAID-induced mucosal lesions distal to the duode num have attracted little attention. We now report on a 31 year old wo man presenting with pronounced anaemia, massive weight loss and episod es of watery diarrhoea. In this case, the long-term use of diclofenac has resulted in multiple ulcerations of the colonic mucosa together wi th stenosis of the ascending colon due to the formation of diaphragm-l ike structures. The patient was submitted to right-sided hemicolectomy . The patient's misuse of diclofenac, which at the time of surgery was not clinically suspected, was not confirmed until seven months later - by the pathologist after analysis of all endoscopic and histologic f indings. Following elimination of the offending substance, the symptom s and disease activity cleared up within a few days. This case shows t hat when lesions of the lower gastrointestinal tract present different ial diagnostic considerations also need to include possible use of NSA IDs.