# 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.

## Key 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.