Abstract
The patient was a 60-year-old male who had suffered from spinal canal stenosis for 30 years and was using NSAIDs (diclofenac sodium) daily. He was admitted to another hospital for abdominal pain and was examined for anemia. He was then transferred to our clinic for ileus treatment. The patient was diagnosed as having small intestinal expansion on the basis of plain abdominal X-ray and CT findings, and a small intestinal obstruction was detected with contrast radiography of the ileus tube. Extreme malnutrition was observed in the patient at the time of transfer to our hospital, and progressive neurological manifestations such as poor articulation and numbness in the extremities appeared later, the causes of which could not be determined. After surgical treatment of the small intestinal obstruction, the patient's general condition, including his neurological manifestations and malnutrition, improved significantly. We made the final diagnosis of NSAID enteropathy on the basis of the pathological finding of a deep ulcer lesion, the absence of other abnormalities such as noncaseating granulomas, and the daily use of NSAIDs by the patient. Thereafter, NSAID administration was discontinued, and no relapse has been noted since then.
