Special Diaphragm-like Strictures of Small Bowel Unrelated to Non-steroidal Anti-inflammatory Drugs

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2011 Oct 12

PMID 21987606

Citations 7

Authors

Ming-Liang Wang

Fei Miao

Yong-Hua Tang

Xue-Song Zhao

Jie Zhong

Fei Yuan

Affiliations

Soon will be listed here.

Abstract

Aim: To summarize clinical, endoscopic, radiologic and pathologic features of special diaphragm-like strictures found in small bowel, with no patient use of non-steroidal anti-inflammatory drugs (NSAIDs).

Methods: From January 2000 to December 2009, 5 cases (2 men and 3 women, with a mean age of 41.6 years) were diagnosed as having diaphragm-like strictures of small bowel on imaging, operation and pathology. All the patients denied the use of NSAIDs. The clinical, endoscopic, radiologic and pathologic findings in these 5 patients were retrospectively reviewed from the hospital database. Images of capsule endoscopy (CE) and small bowel follow-through (SBFT) obtained in 3 and 3 patients, respectively, and images of double-balloon enteroscopy and computed tomography enterography (CTE) obtained in all 5 patients were available for review.

Results: All patients presented with long-term (2-16 years) symptoms of gastrointestinal bleeding and varying degrees of anemia. There was only one stricture in four cases and three lesions in one case, and all the lesions were located in the middle or distal segment of ileum. Circumferential stricture was shown in the small bowel in three cases in the CE image, but the capsule was retained in the small bowel of 2 patients. Routine abdomen computed tomography scan showed no other abnormal results except gallstones in one patient. The lesions were shown as circumferential strictures accompanied by dilated small bowel loops in the small bowel on the images of CTE (in all 5 cases), SBFT (in 2 cases) and double-balloon enteroscopy (in all cases). On microscopy, a chronic inflammatory infiltrate and circumferential diaphragm were found in all lesions.

Conclusion: Diaphragm-like strictures of small bowel might be a special consequence of unclear damaging insults to the intestine, having similar clinical, endoscopic, radiologic and pathologic features.

Citing Articles

A rare presentation of idiopathic small bowel diaphragm disease - A case report.

Ballal R, Ahmed T, Ail D, Colaco S Int J Surg Case Rep. 2023; 112:108966.

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Idiopathic small bowel diaphragm disease: a case report.

Marghich O, Maubert A, Amouzou E, Denimal L, Benizri E, Rahili M J Surg Case Rep. 2020; 2020(10):rjaa358.

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Jejunal diaphragm disease associated with cytomegalovirus infection.

Kagebayashi S, Yamamoto S, Seno H Endosc Int Open. 2019; 7(4):E533-E536.

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Nonsteroidal anti-inflammatory drugs induced diaphragm disease: a report of 3 cases and literature review.

Yang C, Park J, Choi H, Kim D Ann Surg Treat Res. 2018; 94(5):279-283.

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Predictive factors for malignancy in undiagnosed isolated small bowel strictures.

Sonika U, Saha S, Kedia S, Dash N, Pal S, Das P Intest Res. 2017; 15(4):518-523.

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