Ferreira, J.

Küttner-Magalhães, R.

Pedroto, I.

Journal of Gastrointestinal and Liver Diseases

Repositório Científico do Centro Hospitalar do Porto

J Gastrointestin Liver Dis, March 2014 Vol. 23 No 1: 9 Nonsteroidal Anti-Inammatory Drug (NSAID) – Induced Colopathy with Diaphragm-like StricturesRicardo Küttner Magalhães, José Manuel Ferreira, Isabel Pedroto    Department of Gastroenterology, Hospital Santo António, Centro Hospitalar do Porto, PortugalA 79-year-old female patient with coxarthrosis and gonarthrosis had been taking Diclofenac for 10 years. She reported asthenia, abdominal pain in the le upper quadrant and two self-limited episodes of hematochezia in the ve previous months. She had microcytic, hypochromic, sideropenic anemia (hemoglobin: 9.0 g/dL) in spite of several previous packed red blood cells transfusions. Upper endoscopy was not relevant and colonoscopy showed two diaphragm like strictures in the transverse colon (Figs. 1, 2). e most proximal was ulcerated and was not traversable. Histology of these lesions revealed ulceration and inammatory aspect. Small bowel follow-through and CT colonography scan unveiled no additional features. e patient discontinued the nonsteroidal anti-inammatory drugs (NSAIDs) and was directed to Orthopedics and Pain outpatient clinics. One year later she had normal hemoglobin and serum iron levels.e side-eects of NSAIDs in the upper gastrointestinal tract are well described [1], but their action in the distal segments has been increasingly recognized recently. e reported case illustrates the presentation of NSAIDs colopathy as abdominal pain, hematochezia and anemia. is is a rare condition which IMAGE OF THE ISSUEincludes colonic inflammation, ulceration and diaphragm like strictures that are considered to be pathognomonic. Early recognition of its endoscopic aspects is of major importance for diagnosis and prevention of disease progression [2, 3].Corresponding author: R. Küttner Magalhães; rkuttner@gmail.comConicts of interest: None to declare.REFERENCES 1. Sostres C, Gargallo CJ, Arroyo MT, Lanas A. Adverse eects of non-steroidal anti-inammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal tract. Best Pract Res Clin Gastroenterol 2010; 24:121-132. 2. Klein M, Linnemann D, Rosenberg J. Non-steroidal anti-inammatory drug-induced colopathy. BMJ Case Rep 2011; 2011: bcr1020103436. 3. Munipalle PC, Garud T, Light D. Diaphragmatic disease of the colon: systematic review. Colorectal Dis 2013;15:1063-1069.

Nonsteroidal anti-inflammatory drug (NSAID)-induced colopathy with diaphragm-like strictures

http://repositorio.chporto.pt/bitstream/10400.16/1859/1/Nonsteroidal%20anti-inflammatory%20Drug.pdf

Nonsteroidal anti-inflammatory drug (NSAID)-induced colopathy with diaphragm-like strictures

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Repositório Científico do Centro Hospitalar do Porto