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Free peritoneal perforation in Crohn s disease-a rare complication

Dimitriu Anca, Gheorghe C.
Abstract: Free peritoneal perforation is a rare complication of Crohn`s disease. We report the case of a 17 years-old male patient with Ileocolonic and perianal Crohn`s Disease , severe ileitis nonresponsive to anti-TNF alfa medication, who underwent a laparotomy surgery for acute abdomen and was found to have ileal perforation for which segmental enterectomy with ileotransversoanastomosis was performed. The most likely hypothesis is a bowel dilatation above a stenotic area which increased the intraluminal pressure or the inflammatory changes in the blood vessels associated with enteritis possibly contributing to an ischemic cause . Due to high risk of postoperative recurrence of the disease, anti-TNF alfa thearpy was restarted at the same dose at 1 month after surgery. The patient had good early and late postoperative outcomes.

Keywords: Crohn s Disease, Intestinal perforation, Complication of Crohn s Disease, Segmental enterectomy


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