A CASE OF CROHN'S DISEASE CAUSING PERFORATED PERITONITIS

Abstract

This paper presents a case of Crohn's disease causing perforated peritonitis which required emergency operation. A 27-year-old man had loose stool since the age of ten. From he was 20 years old on, abdominal pain, diarrhea, and fever developed several times a year which had been treated by nearby family doctor. At the age of 24, he was diagnosed as Crohn's disease mainly occupying the terminal ileum, with barium enema, double contrast enema of the small intestine and endoscopic biopsy. Protein loosing from the terminal ileum was also detected by RI-image. The patient was conservatively treated with salazopyrin, and steroid. On March 1, 1991, he was admitted to the hospital because of severe abdominal pain and vomiting, and was diagnosed as ileus by stenosis of the ileum which was caused by Crohn's disease. Serum protein was 4.8g/dl. On March 11, he suddenly developed a severe abdominal pain and emergency operation was performed under a diagnosis of panperitonitis. It was found that panperitonitis was caused by perforation in the terminal ileum. Right hemicolectomy including the perforated lesion was performed. The stomas were made from both resected ends. postoperative course uneventful and hypoproteinemia was normalized. Five months later, closure of the stomas was carried out.