TY - JOUR T1 - Small bowel diaphragm disease from long-term non-steroidal anti-inflammatory use JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-230735 VL - 12 IS - 10 SP - e230735 AU - Ryan Pereira AU - Kellee Slater Y1 - 2019/10/01 UR - http://casereports.bmj.com/content/12/10/e230735.abstract N2 - 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. ER -