Abstract
Background: Free perforation of the bowel in Crohn disease is one of the indications for emergency surgery. Spontaneous free perforation is an uncommon event and perforation of the small bowel (jejunum) is rare in Crohn disease. The present study reports a case of spontaneous free perforation of the jejunum in Crohn disease before diagnosis of Crohn disease. Case Presentation: A 24-year-old female presented with a one-month history of intermittent abdominal pain and diarrhea. She had severe abdominal pain and fever and visited the emergency department. An abdominal computed tomography (CT) scan showed small bowel perforation. Emergency exploratory laparotomy was performed. Jejunal perforation with inflammation was present and inflammation was also found intra-operatively at the long segment of the jejunum. Segmental resection was performed on the jejunum. Final pathology of the resected jejunum showed chronic transmural inflammation with ulcer, perforation, stricture, and lymphoid follicles, consistent with Crohn disease.
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