An unexpected finding of large bowel obstruction from colonic diaphragm disease following prolonged use of indomethacin

TL;DR

A patient developed large bowel obstruction due to a colonic stricture caused by long-term NSAID use, initially mistaken for Crohn's disease.

Contribution

Highlights an unusual cause of colonic stricture and large bowel obstruction linked to chronic NSAID use.

Findings

Colonic stricture from indomethacin use caused large bowel obstruction.

Initial misdiagnosis as Crohn's disease occurred in the patient.

NSAID-induced strictures are rare but should be considered in differential diagnosis.

Abstract

Colonic stricture leading to large bowel obstruction is an uncommon presentation to the emergency department. Strictures are commonly established secondary to diverticular disease, inflammatory bowel disease, malignancy or ischaemic/infective colitis. The formation of a colonic stricture secondary to the chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) is an unusual finding. We present a case of a 48-year-old lady who presented with a large bowel obstruction secondary to NSAID-induced right colonic stricture in a patient who was initially thought to have an index presentation of colonic Crohn’s disease.

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