Nonsteroidal anti-inflammatory drug (NSAID)-induced colopathy with diaphragm-like strictures.

A 79-year-old female patient with coxarthrosis and gonarthrosis had been taking Diclofenac for 10 years. She reported asthenia, abdominal pain in the le upper quadrant and two self-limited episodes of hematochezia in the ve previous months. She had microcytic, hypochromic, sideropenic anemia (hemoglobin: 9.0 g/dL) in spite of several previous packed red blood cells transfusions. Upper endoscopy was not relevant and colonoscopy showed two diaphragm like strictures in the transverse colon (Figs. 1, 2). e most proximal was ulcerated and was not traversable. Histology of these lesions revealed ulceration and in ammatory aspect. Small bowel follow-through and CT colonography scan unveiled no additional features. e patient discontinued the nonsteroidal anti-in ammatory drugs (NSAIDs) and was directed to Orthopedics and Pain outpatient clinics. One year later she had normal hemoglobin and serum iron levels. e side-e ects of NSAIDs in the upper gastrointestinal tract are well described [1], but their action in the distal segments has been increasingly recognized recently. e reported case illustrates the presentation of NSAIDs colopathy as abdominal pain, hematochezia and anemia. is is a rare condition which IMAGE OF THE ISSUE