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Case Reports
. 2025 Nov 7;17(11):e96275.
doi: 10.7759/cureus.96275. eCollection 2025 Nov.

The Silent Obstruction: A Rare Complication of Non-steroidal Anti-inflammatory Drug (NSAID)-Induced Diaphragm Disease

Edwin Mazhuppel Rechard  1 , Ismaeel Al-Talib  2 , Radhika Saigal  3 , Lokesh Koumar Sivanandam  4
Affiliations
Case Reports

The Silent Obstruction: A Rare Complication of Non-steroidal Anti-inflammatory Drug (NSAID)-Induced Diaphragm Disease

Edwin Mazhuppel Rechard et al. Cureus. .

Abstract

Diaphragm disease is a rare but significant complication of prolonged non-steroidal anti-inflammatory drug (NSAID) use, characterised by thin concentric mucosal diaphragms causing small bowel strictures. This case report is on a 42-year-old woman with a chronic history of NSAID use, which led to the development of recurrent gastrointestinal symptoms, iron-deficiency anaemia, and subacute small bowel obstruction. Diaphragm disease was confirmed through histological analysis following surgical resection of the small bowel. Patients who present with non-specific GI symptoms along with chronic NSAID use and unexplained obstruction should make us consider diaphragm disease within the differentials.

Keywords: capsule retention; gastrointestinal stricture; small bowel diaphragm disease; small bowel resection; small-bowel obstruction.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Large pyloric gastric ulcer
Figure 2
Figure 2. CT abdomen pelvis. The blue arrow points towards small bowel loops filled with fluids with intervening segment of collapsed bowel. The red arrow points towards diffuse gastric wall oedema, upper abdominal fat stranding, and mild ascites
Figure 3
Figure 3. Abdominal X-ray showing two capsules retained at the terminal ileum
Figure 4
Figure 4. Macroscopic image showing segmentation of the small bowel with incomplete mucosal diaphragms
Figure 5
Figure 5. Microscopic image (H&E stain 0.5x) showing multiple incomplete thin circumferential mucosal diaphragms composed of fibrotic mucosa and submucosa. The black arrow pointing towards fibrosis
See this image and copyright information in PMC

References

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    1. A rare presentation of idiopathic small bowel diaphragm disease - a case report. Ballal RR, Ahmed T, Ail DA, Colaco SM. Int J Surg Case Rep. 2023;112:108966. - PMC - PubMed

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