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Case report
Small bowel diaphragm disease from long-term non-steroidal anti-inflammatory use
  1. Ryan Pereira1,2 and
  2. Kellee Slater1,2
  1. 1 Department of Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  2. 2 Department of Surgery, Greenslopes Private Hospital, Brisbane, Queensland, Australia
  1. Correspondence to Professor Kellee Slater; slaterkellee{at}


Small bowel diaphragm disease (SBDD) is characterised by circumferential lesions of short length (<5 mm), causing intrinsic stenosis of the small bowel lumen. A 63-year-old women with a history of long-term non-steroidal anti-inflammatory use, presented with a 12-month history of intermittent episodes of colicky abdominal pain, nausea and vomiting. Her only past surgery was a laparoscopic hysterectomy. Abdominal CT demonstrated an area of thickening in the mid small bowel, however a diagnostic laparoscopy failed to demonstrate adhesions or any external abnormality. A capsule endoscope did not progress beyond the mid small bowel at the site of a suspected diaphragm. The patient underwent a laparotomy and using the retained capsule as a marker, the area of bowel affected by SBDD was identified. With an ageing population and the widespread use of non-steroidalanti-inflammatory drugs, general surgeons may see an increase in the incidence of SBDD.

  • Gastrointestinal surgery
  • General surgery
  • Small intestine

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  • Contributors RP wrote the original draft of the manuscript. RP and KS performed the literature search, reviewed, edited and approved the final version of the manuscript. Both the listed authors agree with the content of the submitted case report for publication. None of the authors have received any grants, equipment and/or pharmaceutical items requiring declaration. There are no potential conflicts of interest. The case report has not been published previously and is not under consideration elsewhere.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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