Unveiling diaphragm disease in a young female presenting with multiple small bowel strictures: a case report

Diaphragm disease, typically seen in elderly females, manifests as small bowel strictures with diaphragm-like septa, often causing bowel obstruction. We present a case of a young female with chronic abdominal pain and subacute bowel obstruction. She had a prior history of irrational use of non-steroidal anti-inflammatory drugs (NSAIDs), which was discontinued approximately 5 years ago. The initial diagnostics via magnetic resonance enterography (MRE) and capsule endoscopy suggested Crohn's disease due to multiple small bowel strictures. Surgical intervention, including resection and anastomosis, was performed to alleviate the obstruction. Histopathological examination of the resected specimen confirmed diaphragm disease induced by prior NSAID use. This case underscores that diaphragm disease can occur in young individuals without ongoing NSAID exposure and should be considered as a differential diagnosis for Crohn's disease in patients with chronic abdominal pain and subacute bowel obstruction, regardless of their current NSAID usage history.