Digestive Diseases and Sciences

, Volume 39, Issue 6, pp 1365–1369 | Cite as

Duodenal diaphragmlike stricture induced by acetylsalicylic acid

  • Georges H. Blinder
  • Marc L. Hautekeete
  • Joannes P. Holvoet
  • Marc M. Kockx
  • Hubert K. L. Hubens
Case Report

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.

Key words

acetylsalicylic acid NSAID diaphragm disease duodenal stricture 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sturges HF, Krone CL: Ulceration and stricture of the jejunum in a patient on long-term indomethacin therapy. Am J Gastroenterol 59:162–169, 1973Google Scholar
  2. 2.
    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, 1992Google Scholar
  3. 3.
    Neoptolemos JP, Locke TJ: Recurrent small bowel obstruction associated with phenylbutazone. Br J Surg 70:244–245, 1983Google Scholar
  4. 4.
    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, 1986Google Scholar
  5. 5.
    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, 1988Google Scholar
  6. 6.
    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, 1991Google Scholar
  7. 7.
    Huber T, Ruchti C, Halter F: Nonsteroidal antiinflammatory drug-induced colonic stricture: A case report. Gastroenterology 100:1119–1122, 1991Google Scholar
  8. 8.
    Bilbao MK, Frische LH, Rösch J, Benson JA Jr, Dotter CT: Postbulbar duodenal ulcer and ring-stricture. Radiology 100:27–357, 1971Google Scholar
  9. 9.
    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, 1991Google Scholar
  10. 10.
    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, 1988Google Scholar
  11. 11.
    Bjarnasson I, Peters TJ: Intestinal permeability, non-steroidal anti-inflammatory drug enteropathy and inflammatory bowel disease: An overview. Gut Festschrift 1989:22–28, 1989Google Scholar
  12. 12.
    Krieg EG: Duodenal diaphragm. Ann Surg 106:33–41, 1937Google Scholar
  13. 13.
    Nance FC: Intraluminal duodenal diverticula. Surg Gynecol Obstet 125:613–618, 1967Google Scholar
  14. 14.
    Salonen IS: Congenital duodenal obstruction. Acta Paediatr Scand Suppl 272:1–86, 1978Google Scholar
  15. 15.
    Boyden EA, Cope JG, Bill AH: Anatomy and embryology of congenital intrinsic obstruction of the duodenum. Am J Surg 114:190–202, 1967Google Scholar

Copyright information

© Plenum Publishing Corporation 1994

Authors and Affiliations

  • Georges H. Blinder
    • 1
  • Marc L. Hautekeete
    • 1
  • Joannes P. Holvoet
    • 1
  • Marc M. Kockx
    • 1
  • Hubert K. L. Hubens
    • 1
  1. 1.From the Departments of Internal Medicine and PathologyMiddelheim General HospitalAntwerpenBelgium

Personalised recommendations