Small bowel perforation in Crohn's disease: A report of two cases.

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We experienced two cases of small bowel perforation in patients with Crohn's disease. Case 1. A 34-year-old male was admitted to the Tohoku University Hospital with a sudden onset of lower abdominal cramp. Plain abdominal X-ray revealed right subphrenic free air. Laparotomy revealed generalized peritonitis due to a perforated ileum. About 100 cm of the diseased ileum including the area of perforation was resected. Pathological examination revealed severe regional enteritis (Figs. 1, 2). Case 2. A 22-year-old male was admitted to the Tohoku University Hospital with a sudden onset of severe abdominal pain. Abdominal muscular guarding and leucocytosis suggested acute peritonitis. Laparotomy revealed diffuse peritonitis due to a perforated ileum. About 100 cm of the diseased ileum including the perforation was resected. Pathological examination revealed severe regional enteritis.<BR>Small bowel perforation in Crohn's disease is rare because of the nature of the inflam-matory process. Several different surgical approaches have been performed for free perforation of the bowel in Crohn's disease. We propose resection of the diseased bowel including the perforation as the procedure of choice because of the low rates of associated postoperative mortality and complication.
日本大腸肛門病学会の論文