RT Journal Article SR Electronic T1 Small bowel diaphragm disease from long-term non-steroidal anti-inflammatory use JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e230735 DO 10.1136/bcr-2019-230735 VO 12 IS 10 A1 Ryan Pereira A1 Kellee Slater YR 2019 UL http://casereports.bmj.com/content/12/10/e230735.abstract AB 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.