NSAID-induced small bowel diaphragms and strictures diagnosed with intraoperative enteroscopy

Nonsteroidal anti-inflammatory drugs are known to cause mucosal damage in t he stomach and duodenum, which may lead to hemorrhage and perforation. Howe ver, these medications may also cause damage in the more distal small bowel . Due to the location of these lesions, currently available diagnostic test ing may yield false negative results. Two cases of nonsteroidal anti-inflam matory drug-induced small bowel diaphragms presenting as obscure gastro int estinal hemorrhage and recurrent small bowel obstruction, respectively, are discussed. Intraoperative enteroscopy was used to confirm this diagnosis a fter other diagnostic tests failed to identify the etiology. This procedure may increase the accuracy of exploratory laparotomy in these challenging c ases.