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Purpose: To identify the clinical and radiologic findings in patients with diaphragm-like strictures in the small bowel., Patients and Methods: We reviewed the histories, radiologic findings, and pathologic findings in two men and two women, all in their sixties, with a history of long-term nonsteroidal antiinflammatory drug (NSAID) or aspirin (ASA) usage and one or more radiologically demonstrated diaphragm-like strictures in the small bowel., Results: Two patients had long histories of NSAID usage, and two of ASA usage. One NSAID user had a long segment of jejunal involvement, and the other three had short segments of duodenal involvement. The ASA users presented with symptoms of esophageal disease, the small bowel lesions were unexpected, and ASA usage was not initially elicited. In one NSAID user and one ASA user, broader strictures with humps rather than diaphragms were also seen producing a lifesaver-like or bagel-like configuration., Conclusions: Multiple diaphragm-like strictures can occur in NSAID injury and are pathognomonic except in the rare patient with ulcerative enteritis complicating celiac disease. Single or few diaphragm-like strictures can occur in NSAID injury and peptic ulceration. ASA should be considered an NSAID with regard to small-bowel toxicity. A careful medication history is required when an unexplained small bowel abnormality is seen radiologically, and a dedicated small bowel examination is required when NSAID injury is suspected.

A case of adenocarcinoma of the rectum occurring 17 years after pelvic irradiation for squamous carcinoma of the cervix is reported. Earlier colonic resection had shown localized colitis cystica profunda in a radiation-induced colonic stricture. Colorectal cancer is an infrequent sequel to radiotherapy, which may occur many years after treatment of the primary tumor. Prolonged follow-up of these patients is essential.