Small-bowel diaphragm disease

Seven surgical cases

Michael E. Kelly, Lisa E. McMahon, Dawn E. Jaroszewski, Mahmoud M. Yousfi, Giovanni De Petris, James M. Swain

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Hypothesis: Small-bowel diaphragm disease is an important source of gastrointestinal tract bleeding and subacute intestinal obstruction that may require surgical intervention. Design: Case series. Setting: Tertiary-care academic medical center. Patients: Seven consecutive patients with histologically confirmed enteropathy induced by use of nonsteroidal anti-inflammatory drugs received treatment at our institution from February 2001 to February 2004. Interventions: Laparotomy with small-bowel resection. Main Outcome Measures: Initial symptoms and signs, findings at diagnostic workup, type of medication and duration of use, operation performed, and intraoperative findings were evaluated. Results: Patients were identified who had symptoms of subacute intestinal obstruction or signs of gastrointestinal tract bleeding and were determined to have used nonsteroidal anti-inflammatory drugs for differing periods. All 7 patients underwent extensive nondiagnostic radiologic and endoscopic examinations. The diagnosis of diaphragm disease was ultimately made at either video capsule endoscopy or laparotomy. Randomly distributed diaphragms throughout the jejunum and ileum necessitated resection in all cases. No patient has had a documented recurrence, although follow-up is short (range, 0-20 months). Conclusions: Nonsteroidal anti-inflammatory drugs are clearly linked to pathologic findings of diaphragm disease in both the upper and lower gastrointestinal tracts. Although rarely reported in the surgical literature, small-bowel diaphragm disease may be more common than thought and can manifest as gastrointestinal tract bleeding or obstruction. Diagnosis is difficult and may require laparotomy and small-bowel resection.

Original languageEnglish (US)
Pages (from-to)1162-1166
Number of pages5
JournalArchives of Surgery
Volume140
Issue number12
DOIs
StatePublished - Dec 2005

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Diaphragm
Laparotomy
Gastrointestinal Tract
Anti-Inflammatory Agents
Intestinal Obstruction
Hemorrhage
Lower Gastrointestinal Tract
Pharmaceutical Preparations
Capsule Endoscopy
Upper Gastrointestinal Tract
Tertiary Healthcare
Jejunum
Ileum
Signs and Symptoms
Outcome Assessment (Health Care)
Recurrence
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Kelly, M. E., McMahon, L. E., Jaroszewski, D. E., Yousfi, M. M., De Petris, G., & Swain, J. M. (2005). Small-bowel diaphragm disease: Seven surgical cases. Archives of Surgery, 140(12), 1162-1166. https://doi.org/10.1001/archsurg.140.12.1162

Small-bowel diaphragm disease : Seven surgical cases. / Kelly, Michael E.; McMahon, Lisa E.; Jaroszewski, Dawn E.; Yousfi, Mahmoud M.; De Petris, Giovanni; Swain, James M.

In: Archives of Surgery, Vol. 140, No. 12, 12.2005, p. 1162-1166.

Research output: Contribution to journalArticle

Kelly, ME, McMahon, LE, Jaroszewski, DE, Yousfi, MM, De Petris, G & Swain, JM 2005, 'Small-bowel diaphragm disease: Seven surgical cases', Archives of Surgery, vol. 140, no. 12, pp. 1162-1166. https://doi.org/10.1001/archsurg.140.12.1162
Kelly ME, McMahon LE, Jaroszewski DE, Yousfi MM, De Petris G, Swain JM. Small-bowel diaphragm disease: Seven surgical cases. Archives of Surgery. 2005 Dec;140(12):1162-1166. https://doi.org/10.1001/archsurg.140.12.1162
Kelly, Michael E. ; McMahon, Lisa E. ; Jaroszewski, Dawn E. ; Yousfi, Mahmoud M. ; De Petris, Giovanni ; Swain, James M. / Small-bowel diaphragm disease : Seven surgical cases. In: Archives of Surgery. 2005 ; Vol. 140, No. 12. pp. 1162-1166.
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