Crohn’s Perforation: Not so Uncommon in the Indian Population

Abstract

Crohn's Disease is a chronic, idiopathic, transmural inflammatory disease affecting predominantly distal ileum, the common presentation include stricture and fistula formation. Free perforation in the peritoneal cavity is rare. To study the presentation and management of Crohn's perforation. A retrospective study of 9 cases of perforative peritonitis later diagnosed due to Crohn's disease on histopathological examination. Among the 9 patients, 8 were males and 1 was female. The ages of the patients ranged from 30 to 58years, with mean age of 41.8years. 6 patients were in the age group of 30-45years. 8 patients were not known to be suffering from Crohn's. Resection followed by anastomosis was done in 4 cases including the case of known Crohn's, while resection follwed by end illeostomy with mucous fistula was done in remaining cases. Resected specimens were sent for histopathological examination in all cases. Though Crohn's perforation is rare it should be kept in mind when dealing with single or multiple perforation of the small intestine even in the developing countries. Though the number of cases in our series are too few to come to a conclusion, we found that illeostomy sems a prudent alternative to traditional resection anastomosis.