Diaphragm disease compared with cryptogenic multifocal ulcerous stenosing enteritis.

As the use of drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) increases, so too do gastrointestinal ulcers, bleeding, perforation and obstruction. Diaphragm disease of the small intestine is formed by submucosal fibrosis and destruction of lamina muscularis due to chronic ulceration, which corresponds to the most severe stage of NSAID enteropathy. It may lead to stricture of the small intestine. If such ulcerations and strictures in the small intestine are multiple, differential diagnosis is between diaphragm disease and cryptogenic multifocal ulcerous stenosing enteritis (CMUSE), because the gross findings of diaphragm disease are similar to those of CMUSE. We report a rare case of diaphragm disease caused by NSAID. It has been finally confirmed by capsule endoscopy and the origin of chronic obscure gastrointestinal bleeding was found to be multiple ulcers and strictures in the small intestine. After operation, we diagnosed the patient with diaphragm disease rather than CMUSE.