Kwo P Y, Tremaine W J
Division of Gastroenterology, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1995 Jan;70(1):55-61. doi: 10.1016/S0025-6196(11)64666-1.
The adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the upper gastrointestinal tract are well described. Evidence also shows that NSAIDs can be harmful to the small intestine. The use of NSAIDs has been associated with small intestinal strictures, ulcerations, perforations, diarrhea, and villous atrophy. Herein we present a case of NSAID-induced enteropathy with multiple diaphragm-like strictures that involved the distal 35 cm of ileum and review the literature of other cases of NSAID-induced enteropathy in which biopsy specimens were obtained for histologic analysis to rule out other causes. The prevalence of NSAID-induced enteropathy is unknown. Diagnosis can be made by endoscopy or at abdominal exploration. The role of radionuclide scans for diagnosis remains unclear. The pathogenesis is likely multifactorial. Mucosal diaphragms may be specific for NSAID-related disease. Treatment options for NSAID-induced enteropathy are discussed.
非甾体抗炎药（NSAIDs）对上消化道的不良反应已有充分描述。证据还表明，NSAIDs可能对小肠有害。使用NSAIDs与小肠狭窄、溃疡、穿孔、腹泻和绒毛萎缩有关。在此，我们报告一例NSAIDs诱导的肠病，其具有多个隔膜样狭窄，累及回肠远端35厘米，并回顾其他NSAIDs诱导肠病病例的文献，在这些病例中获取了活检标本进行组织学分析以排除其他病因。NSAIDs诱导肠病的患病率尚不清楚。可通过内镜检查或腹部探查做出诊断。放射性核素扫描在诊断中的作用仍不明确。其发病机制可能是多因素的。黏膜隔膜可能是NSAIDs相关疾病所特有的。本文还讨论了NSAIDs诱导肠病的治疗选择。
