BACKGROUND: Free bowel perforation is one of the indications for emergency surgery in Crohn's disease. It is generally accepted that 1-3% of patients with Crohn's disease will present with a free perforation initially or eventually in their disease course. OBJECTIVES: To evaluate the incidence and treatment results of free perforation in patients with Crohn's disease and, based on our experience, to suggest recommendations. METHODS: Between 1987 and 1996, 160 patients with Crohn's disease were treated in our department and were followed for a mean period of 5 years. RESULTS: Of the 83 patients (52%) requiring surgical intervention, 13 (15.6%) were operated due to free perforation. The mean age of the perforated CD was 33 +/- 12 years and the mean duration of symptoms prior to surgery was 6 years. The location of the free perforation was the terminal ileum in 10 patients, the mid-ileum in 2 patients, and the left colon in 1 patient. Surgical treatment included 10 ileocecectomies, 2 segmental resections of small bowel, and resection of left colon with transverse colostomy and mucus fistula in one patient. There was no operative mortality. Postoperative hospital stay was 21 +/- 12 days (range 8-55 days). All patients were followed for 10-120 months (mean 58.0 +/- 36.7). Six patients (42%) required a second operation during the follow-up period. CONCLUSION: The incidence of free perforation in Crohn's disease in our experience was 15.6%. We raise the question whether surgery should be offered earlier to Crohn's disease patients in order to lower the incidence of free perforation.
BACKGROUND: Free bowel perforation is one of the indications for emergency surgery in Crohn's disease. It is generally accepted that 1-3% of patients with Crohn's disease will present with a free perforation initially or eventually in their disease course. OBJECTIVES: To evaluate the incidence and treatment results of free perforation in patients with Crohn's disease and, based on our experience, to suggest recommendations. METHODS: Between 1987 and 1996, 160 patients with Crohn's disease were treated in our department and were followed for a mean period of 5 years. RESULTS: Of the 83 patients (52%) requiring surgical intervention, 13 (15.6%) were operated due to free perforation. The mean age of the perforated CD was 33 +/- 12 years and the mean duration of symptoms prior to surgery was 6 years. The location of the free perforation was the terminal ileum in 10 patients, the mid-ileum in 2 patients, and the left colon in 1 patient. Surgical treatment included 10 ileocecectomies, 2 segmental resections of small bowel, and resection of left colon with transverse colostomy and mucus fistula in one patient. There was no operative mortality. Postoperative hospital stay was 21 +/- 12 days (range 8-55 days). All patients were followed for 10-120 months (mean 58.0 +/- 36.7). Six patients (42%) required a second operation during the follow-up period. CONCLUSION: The incidence of free perforation in Crohn's disease in our experience was 15.6%. We raise the question whether surgery should be offered earlier to Crohn's diseasepatients in order to lower the incidence of free perforation.
Authors: Raquel Franco Leal; Marc Ward; Maria de Lourdes Setsuko Ayrizono; Nielce Maria de Paiva; Emanuelle Bellaguarda; Débora Helena Gonçalves Rossi; Natália Pranzetti Vieira; João José Fagundes; Cláudio Saddy Rodrigues Coy Journal: Int J Surg Case Rep Date: 2013-01-23
Authors: Belinda De Simone; Justin Davies; Elie Chouillard; Salomone Di Saverio; Frank Hoentjen; Antonio Tarasconi; Massimo Sartelli; Walter L Biffl; Luca Ansaloni; Federico Coccolini; Massimo Chiarugi; Nicola De'Angelis; Ernest E Moore; Yoram Kluger; Fikri Abu-Zidan; Boris Sakakushev; Raul Coimbra; Valerio Celentano; Imtiaz Wani; Tadeja Pintar; Gabriele Sganga; Isidoro Di Carlo; Dario Tartaglia; Manos Pikoulis; Maurizio Cardi; Marc A De Moya; Ari Leppaniemi; Andrew Kirkpatrick; Vanni Agnoletti; Gilberto Poggioli; Paolo Carcoforo; Gian Luca Baiocchi; Fausto Catena Journal: World J Emerg Surg Date: 2021-05-11 Impact factor: 5.469
Authors: S K Doklestić; D D Bajec; R V Djukić; V Bumbaširević; A D Detanac; S D Detanac; M Bracanović; R A Karamarković Journal: J Med Life Date: 2014-06-25