Bennett Stephen, Martin Jack, Mahler-Araujo Betania, Gourgiotis Stavros
Cambridge Oesophago-Gastric Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
Cambridge Oesophago-Gastric Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
BMJ Case Rep. 2020 Feb 6;13(2):e233537. doi: 10.1136/bcr-2019-233537.
Diaphragm disease (DD) of the small bowel is a rarely reported complication of non-steroidal anti-inflammatory drug (NSAID) use, characterised by diaphragm-like strictures, most commonly in the ileum, causing varying degrees of obstruction. It typically presents in the elderly, over many years with non-specific symptoms. Diagnosis is challenging, the majority of cases relying on histopathology for confirmation. Treatment involves NSAID cessation and surgery through a combination of stricturoplasties and/or segmental resection. Very rarely DD presents as a surgical emergency. A case presenting as acute small bowel obstruction (SBO) is described, initially diagnosed as adhesions, later confirmed to be DD of the terminal ileum following histopathological examination. Given the widespread use of NSAIDs and an ageing population, it is likely the incidence of DD will increase. It is, therefore, important that surgeons are aware of this disease entity and consider it as a potential diagnosis in patients presenting with acute SBO.
小肠膈膜病（DD）是一种使用非甾体抗炎药（NSAID）后罕见报道的并发症，其特征为膈膜样狭窄，最常见于回肠，可导致不同程度的梗阻。它通常在老年人中出现，多年来伴有非特异性症状。诊断具有挑战性，大多数病例依靠组织病理学进行确诊。治疗包括停用NSAID以及通过狭窄成形术和/或节段性切除相结合的手术。DD极少表现为外科急症。本文描述了一例表现为急性小肠梗阻（SBO）的病例，最初诊断为粘连，经组织病理学检查后确诊为回肠末端DD。鉴于NSAIDs的广泛使用和人口老龄化，DD的发病率可能会增加。因此，外科医生了解这种疾病实体并将其视为急性SBO患者的潜在诊断很重要。
