A case report of non-steroidal anti-inflammatory induced colitis

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The case was a 47-year-old man. He was admitted for Mallory-Weiss syndrome. He was administered a total of 900 mg diclofenac sodium for fever and abdominal pain for 9 days. On day 10, colonoscopy was performed for colon obstruction diaphragm-like stenosis, and endoscopic expansion was performed for splenic flexure obstruction. Recurrence of ileus appeared and so colonoscopy was performed again. The splenic flex part was only slightly enlarged, but stenosis on the ileum end was detected. We tried to perform endoscopic expansion but it was difficult because the stenosis area was in the ileocecum region. Therefore, ileocecum resection was performed on day 32 after onset. Although dimple-shaped scarring was observed in the serosa of the area of stricture of the terminal ileum and pathological findings showed the formation of an ulcer in the muscle layer, there were only non-specific findings without vasculitis or the formation of granuloma was noted. Based on the clinical course and the non-specific pathological findings, NSAID enteropathy was diagnosed.