ACUTE FREE PERFORATION OF THE SMALL INTESTINE IN CROHN'S DISEASE
| Autor: | Minoru Okumura, Muhekastu Sato, Atsushi Takahashi, Hironori Yamaguchi, Naoki Nakatsubo |
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| Rok vydání: | 1998 |
| Předmět: | |
| Zdroj: | Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association). 59:1295-1299 |
| ISSN: | 1882-5133 1345-2843 |
| DOI: | 10.3919/jjsa.59.1295 |
| Popis: | Crohn's disease is non-caseous granulomatous inflammatory disease affecting from the oral cavity through anus discontinously and transemurally. It is often complicated by stricture, fistulization, abscess formation, and bleeding, but free perforarion is a very rare complication of the disease. Since 1935 when Arnheim first stated this complication, it has been increasingly reported in Japan, and 108 cases can be seen in the literature. This paper reports a case of perforation of the small intestine due to Crohn's disease. A 34-year-old man was seen at the hospital becaused of sever right lower quadurant pain with tenderness, muscle gurding, and rebound tenderness. The patient was operated on immediately under a diagnosis of acute peritonitis. A thickening of the ileum was observed over about 35cm in length at a site about 10cm from the ileocecal junction. A perforation of the terminal ileum 30cm from the ileocecal junction at the mesenteric border was seen. After intraperitoneal irrigation, a part of the ileum was excised. The resected specimen showed longitudinal ulcer, and Crohn's disease of the intestine was diagnosed histpathologically. The postoperative follow-up of this patient has continued for 6 months, and so far there has been no sign of recurrence. This patient presented with abrupt abdominal pain and fever without any prodrome, and was suspected of having Crohn's disease when an emergency operation was conducted with a diagnosis of perforative peritonitis. Some notes in terms of acute abdomen of the disease are also presented here. |
| Databáze: | OpenAIRE |
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