Da. Shumaker et al., NSAID-induced small bowel diaphragms and strictures diagnosed with intraoperative enteroscopy, CAN J GASTR, 15(9), 2001, pp. 619-623
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.