Special diaphragm-like strictures of small bowel unrelated to non-steroidal anti-inflammatory drugs

Figure 1 Sixty-four-year-old woman presenting with 16 years of intermittent black stools. A: Circumferential stricture seen on capsule endoscopy image; B: Double-balloon enteroscopy image shows an unusual diaphragm-like stricture in the ileum and the retained capsule; C: Computed tomography enterography image (oblique MPR) showing two diaphragm-like strictures and capsule retention in a dilated small bowel loop in the ileum (arrows); D: Diaphragm-like strictures and capsule retention in a dilated small bowel loop shown by small bowel follow-through (arrows); E: Longitudinal section of specimen containing laterigrade diaphragms and a retained capsule endoscope in the middle, and a laterigrade ulcer can be seen in one of the diaphragms (arrows).

Figure 2 Thirty-one-year-old woman presenting with a 3-year history of recurrent episodes of abdominal pain, incomplete intestinal obstruction and intermittent black stools. A: Double-balloon enteroscopy image showing circumferential diaphragm-like stricture in the ileum (arrow); B: Computed tomography enterography image (oblique multiplanar reconstruction) showing mild bowel expansion in the ileum with a diaphragm-like stricture in the middle (arrow); C: A diaphragm-like stricture in the middle can be seen in the iliac specimen; D: Longitudinal section of specimen containing a laterigrade ulcer.

Figure 3 Forty-four-year-old woman presenting with a 4-year history of recurrent episodes of hematochezia and abdominal pain. A: Double-balloon enteroscopy image showing circumferential stricture in the ileum; B: Computed tomography (CT) plain scan image showing mild bowel wall thickening and circumferential stricture of the lumen in the ileum (arrow); C: Contrast-enhanced CT scan image showing that contrast enhancement of thickened bowel wall is homogenous and moderate (arrow); D: Blood vessel with thickened wall and expanded lumen shown in the submucosa (hematoxylin and eosin, orig. mag × 40).