Free perforation of the small bowel in Crohn's disease

Croft, Rodney J.

doi:10.1136/pgmj.53.620.344

Cited by 7 publications

(5 citation statements)

References 10 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our cases 1 and 3, a primary resection of the perforated bowel with an ileocolic end-to-end anastomosis was performed without complications. The same results have been reported by other authors recently [4,[6][7][8][11][12][13].…”

Section: Discussionsupporting

confidence: 91%

“…A small infarct of part of the intestinal wall or a large fissure may perforate the whole intestinal wall in cases of acute presentation of regional enteritis. Obstruction may have a role in the pathogenesis of free perforation in cases of chronic Crohn's disease, when a diseased bowel perforates proximal to the obstruction [4,11]. Steroids do not play a role in the causation of perforation in Crohn's disease, according to Steinberg et al [4].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Free perforation of the small bowel in Crohn's disease

et al. 1982

View full text Add to dashboard Cite

Three patients with an uncommon complication of Crohn's disease are presented. A free perforation of the diseased terminal ileum was found at laparotomy in all patients. Pneumoperitoneum was not seen on x-ray. They all underwent emergency surgery with a tentative diagnosis of acute appendicitis and/or generalized peritonitis. The surgical management is described.The literature was reviewed regarding free perforation of the small bowel in Crohn's disease. The clinical and radiologicai findings of this condition are described. Simple suture of the perforation should be avoided because of the high mortality (33%) and complications rates (44%) recorded in the literature with this surgical procedure. According to the limited world experience, resection of the diseased bowel is the treatment of choice in these patients.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Free perforation of the small bowel in Crohn's disease

et al. 1982

View full text Add to dashboard Cite

show abstract

“…28,29 No stigmata of ischemic etiology such as microthrombi or granulomas were observed in the areas of perforation on our patient’s pathological examination. Other reports of patients with multiple synchronous small bowel perforations either demonstrate pathology consistent with classic Crohn’s ulceration and transmural inflammation without necrosis 26 or do not comment on any atypical histopathology. 21,24 Our case is also unique in that our patient suffered 3 separate episodes of small bowel perforation, of which there is only one other report in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical characteristics of patients with Crohn's disease experiencing free perforation of the small intestine vary widely. A review of individual case reports (Table 1) 1,6,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] and larger series demonstrates an even distribution of this complication in males and females. 2,3 Furthermore, cases of free perforation have been documented in a broad range of ages as young as 11-24 years and as old as 66 years.…”

Section: Discussionmentioning

confidence: 99%

Small Intestinal Perforation Secondary to Necrotizing Enteritis—An Under-Recognized Complication of Crohn’s Disease

Huerta

Ribieras

Kodia

et al. 2022

The American Surgeon™

View full text Add to dashboard Cite

Small bowel perforation is an uncommon but severe event in the natural history of Crohn’s disease with fewer than 100 cases reported. We review Crohn’s disease cases with necrotizing enteritis and share a case of a 26-year-old female who presented with a recurrent episode of small intestinal perforation. A PubMed literature review of case reports and series was conducted using keywords and combinations of “Crohn’s disease,” “small intestine perforation,” “small bowel perforation,” “free perforation,” “regional enteritis,” and “necrotizing enteritis.” Data extracted included demographic data, pre- or postoperative steroid administration, medical or surgical management, and case fatality. Nineteen reports from 1935 to 2021 qualified for inclusion. There were 43 patients: 20 males and 23 females with a mean age of 36 ± 15 years old. 75 total perforations were described: 56 ileal (74.6%), 15 jejunal (20.0%), 2 cecal (2.7%), and 1 small intestine non-specified (2.7%). 38 of 43 patients were managed surgically by primary repair (11), ostomy creation (21), or an anastomosis (11). Of 11 case fatalities, medical management alone was associated with higher mortality (5/5; 100% mortality) compared to those treated surgically (6/38; 15.8% mortality; P < .001). Patient sex, disease history, acute abdomen, and pre- or postoperative steroid use did not significantly correlate with mortality. Jejunal perforation was significantly ( P = .028) associated with event mortality while ileal was not ( P = .45). Although uncommon, necrotizing enteritis should be considered in Crohn’s patients who present with small intestinal perforation. These cases often require urgent surgical intervention and may progress to fulminant sepsis and fatality if not adequately treated.

show abstract

“…Another unusual complication of Crohn's disease is free perforation. Croft (1977) reports a case of double perforation of the small bowel treated successfully by an emergency right hemicolectomy. About a 100 cases have previously been reported and there is no definite association with previous or current steroid therapy.…”

Section: Duodenal Ulcerationmentioning

confidence: 99%

Review of general surgery 1977

Ellis

1978

Postgraduate Medical Journal

View full text Add to dashboard Cite

Free perforation of the small bowel in Crohn's disease

Cited by 7 publications

References 10 publications

Free perforation of the small bowel in Crohn's disease

Free perforation of the small bowel in Crohn's disease

Small Intestinal Perforation Secondary to Necrotizing Enteritis—An Under-Recognized Complication of Crohn’s Disease

Review of general surgery 1977

Contact Info

Product

Resources

About