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Free perforation in Crohn's disease.
Nahum Werbin1, Riad Haddad, Ron Greenberg
1Department of Surgery A, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
The Israel Medical Association Journal : IMAJ
|May 3, 2003
Summary
Free bowel perforation in Crohn's disease (CD) occurred in 15.6% of surgical patients. Early surgical intervention may reduce the incidence of free perforation in CD patients.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Free bowel perforation is a critical surgical indication in Crohn's disease (CD).
- 1-3% of CD patients experience free perforation during their disease course.
Purpose of the Study:
- To determine the incidence and treatment outcomes of free bowel perforation in CD patients.
- To propose recommendations based on clinical experience.
Main Methods:
- Retrospective analysis of 160 CD patients treated between 1987 and 1996.
- Mean follow-up period of 5 years for all patients.
Main Results:
- 13 out of 83 surgically treated CD patients (15.6%) underwent surgery for free perforation.
- Most perforations occurred in the terminal ileum; surgical treatments included ileocecectomy and segmental resections.
- No operative mortality was observed, but 42% of patients required a second surgery during follow-up.
Conclusions:
- The incidence of free perforation in this CD cohort was 15.6%.
- The study questions whether earlier surgical intervention could decrease the rate of free perforation in Crohn's disease.