Abstract
The patient, a 27 year-old man, was admitted to the hospital with complaints of abdominal pain, diarrhea, fever and loss of body weight. Physical examination showed diffuse tenderness of the abdomen, but no peritoneal irritation. Plain abdominal X-ray revealed no free air under the diaphragma. initial laboratory data showed abnormal ESR, CRP, WBC, thrombocytes and serum cholesterol. As his condition did not improve in spite of various conservative treatments, operation was done 15 days later. We diagnosed this case as Crohn's disease from multiple skip stenoses of the small bowel and so-called creeping sign. We also encountered perforation and abscess of the terminal ileum. Until recently, 36 cases of Crohn's disease associated with perforation have been reported in Japan. We report another rare case of Crohn's disease and consider that in such cases double-contrast study of the small intestine should be done.
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