Duodenal diverticulum complicated by duodenal inflammation and obstruction secondary to the use of the NSAID diclofenac

In one patient, upper abdominal symptoms developed 6 months after the start of diclofenac. At upper gastrointestinal endoscopy duodenal stenosis was shown next to a large diverticulum containing non-dissolved tablets in the third part of the duodenum. As there was no improvement with medical treatment, resection of the diverticulum and stenosis with primary end-to-end anastomosis was performed. Apart from persistent activity of rheumatoid arthritis the patient has been well since. The possible gastrointestinal side-effects of nonsteroidal antiinflammatory drugs in patients with duodenal diverticula are discussed.