{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:39:36Z","timestamp":1762522776546,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,12,23]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>Diaphragm disease is a rare cause of small bowel obstruction, caused by circular fibrotic membranes resulting in a narrowed intestinal lumen. It is associated with prolonged non-steroidal anti-inflammatory drug use, and often requires surgical resection. We report the case of a man in his 50s presenting with recurrent anaemia and intermittent small bowel obstruction. Exploratory laparoscopy identified three distinct areas of congested, thickened and narrowed ileum. Symptoms resolved following small bowel resection. Histological examination found elongated mucosal folds with ulceration and submucosal fibrosis consistent with diaphragm disease. Common radiological findings include small bowel strictures and thickening, mucosal hyperenhancement, and small bowel dilatation. In this case, on retrospective review of the initial CT scan, it is possible to appreciate circumferential mural thickening correlating with the histological findings. This case highlights the importance of rigorous examination of CT imaging and the utility of exploratory laparoscopy in diagnosing diaphragm disease.<\/jats:p>","DOI":"10.1136\/bcr-2022-253707","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T10:45:13Z","timestamp":1673001913000},"page":"e253707","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Rare cause of small bowel obstruction: diaphragm disease"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2086-4714","authenticated-orcid":false,"given":"Peter","family":"Foulser","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Epsom and Saint Helier University Hospitals NHS Trust Epsom Hospital, Epsom, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alhamza","family":"Al-Khatib","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Epsom and Saint Helier University Hospitals NHS Trust Epsom Hospital, Epsom, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Moodie","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Epsom and Saint Helier University Hospitals NHS Trust Epsom Hospital, Epsom, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippa","family":"Youd","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Epsom and Saint Helier University Hospitals NHS Trust Epsom Hospital, Epsom, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"2025082710193257000_16.1.e253707.1","doi-asserted-by":"publisher","DOI":"10.1309\/7DDT5TDVB5C6BNHV"},{"key":"2025082710193257000_16.1.e253707.2","first-page":"182","article-title":"Small bowel diaphragm disease--strictures associated with non-steroidal anti-inflammatory drugs","volume":"61","author":"McCune","year":"1992","journal-title":"Ulster Med J"},{"key":"2025082710193257000_16.1.e253707.3","doi-asserted-by":"crossref","unstructured":"Levi S , de Lacey G , Price AB , et al . \u201cDiaphragm-like\u201d structures of the small bowel in patients treated with non-steroidal anti-inflammatory drugs. 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