Duodenal Small Bowel Diaphragm Disease: A Rare and Underrecognized Complication of Chronic NSAID Use

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications. Although common adverse effects such as gastrointestinal bleeding, ulcers, and kidney injury are widely known, small bowel diaphragm disease, an exceedingly rare complication of long-term NSAID use, remains underrecognized. We report an uncommon case of a 56-year-old patient on long-term high-dose NSAIDs who developed diaphragm disease involving the duodenum, a rarely reported location, manifesting as intestinal obstruction. This case highlights the potential for unusual anatomical involvement to mask diagnosis and underscores the importance of early consideration of this diagnosis in patients with chronic NSAID use and unexplained obstructive presentations.