[Diaphragm-like strictures of the colon from diclofenac]

Abstract

Background: Diaphragm-like strictures of the colon induced by nonsteroidal antiinflammatory drugs (NSAID) constitute a recently described uncommon clinical entity.

Case report: An 86-year-old man consulted for abdominal pain and constipation. The physical examination revealed bloody stools and anemia in a patient on long-standing diclofenac therapy. Colonoscopy demonstrated two diaphragm-like strictures of the left and transverse colon with ulceration of the apex. Clinical outcome was favorable after discontinuing the NSAID.

Discussion: We compared this observation with 26 other case reports in the literature. The etiological mechanism appears to be related to systemic and local toxicity. Severe stenotic stricture may require surgical management. Endoscopic pneumatic dilatation may be an alternative to surgery.