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

Table 1 Clinical data of study patients

Case	Sex	Age at onset(yr)	Age at diagnosis(yr)	Past history	Main symptoms		Physicalexamination	HGB(g/dL )	WBC count(×109/L )
					GI bleeding	Abdominal pain
1	F	30	33	Gallbladder stone	P	P	Normal	9.0	3.2
2	F	48	64	No		P	Normal	5.8-9.6	4.1
3	M	24	26	Appendectomy		N	Normal	10.9	5.3
4	F	40	44	Hysteromyoma	P	P	Normal	9.2	5.7
5	M	32	41	No	P	N	Normal	9.7	5.0

F: Female; M: Male; P: Positive; N: Negative; GI: Gastrointestinal; HGB: Hemoglobin; WBC: White blood cell.

Table 2 Data of enteroscopic findings

Case	n	Location (distance to ileocecal valve)(cm)	Type of lesion	Stricture		Edema in mucosa	Pass-through of scope
				Mild to moderate	Severe
1	1	80	Ulcer	1	0	P	P
2	3	100-115	Ulcer and erosion	1	2	P	P
3	1	100	Ulcer	1	0	P	P
4	1	80	Ulcer	1	0	P	P
5	1	150	Erosion	0	1	P	P

P: Positive; N: Negative.

Table 3 Data of computed tomography findings

Case	Location	n	Stenosis	Lumen expansion	Bowel wall			Mesentericvessels	Lymph nodeenlargement
					Thickness (mm)	Attenuation	Enhancement
1	Ileum	1	P	P	2.5	Isodense	Moderate	Normal	N
2	Ileum	2	P	P	7	Isodense	Moderate	Normal	N
3	Ileum	1	N	P	3	Isodense	Moderate	Normal	P
4	Ileum	1	P	P	2.5	Isodense	Moderate	Normal	N
5	Ileum	1	P	P	5	Isodense	Moderate	Normal	N

P: Positive; N: Negative.

Table 4 Data of histologic findings

Case	Size1 (cm)	Type	Depth1	Inflammatoryinfiltrate	Fibrosis	Mucosalatrophy	Thickening ofmuscularis mucosa	Edema insubmucosa
1	2.0 × 0.5	Ulcer	Muscular layer	Moderate	Mild	N	Mild	N
22	2.0 × 0.2	Ulcer	Muscular layer	Severe	Mild	N	Moderate	N
3	3.0 × 0.2	Ulcer	Submucosa	Severe	Moderate	N	N	P
4	3.0 × 0.5	Ulcer	Submucosa	Severe	Moderate	N	Moderate	P
5	2.0 × 0.5	Erosion	Mucosa	Moderate	None	N	N	N

¹Means the size and depth of ulcer or erosion of specimen;

²Information of the most narrow lesion. P: Positive; N: Negative.

Table 5 Differences between diaphragm disease of non-steroidal anti-inflammatory drug-enteropathy and diaphragm-like strictures in study group

	History	Location	n	Fibrosis	Lesions in other area ofbowel	Disease process
Diaphragm disease	Long term NSAID use	Whole GI tract, most frequently in ileum	Multiple	Obvious	Exist, can be inflammation, erosion, fibrosis, stricture and perforation	Improvement in clinical findings by cessation of NSAID utilization
Diaphragm-like strictures	No NSAID use	Middle or distal segment of ileum	Usually single, no more than three	Mild or moderate	No	Non-self-limiting

NSAID: Non-steroidal anti-inflammatory drug; GI: Gastrointestinal.