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A rare surgical complication of Crohn's diseases: free peritoneal perforation

M Veroux1, I Angriman, C Ruffolo

  • 1Department of Surgery and Transplantation, University Hospital, Catania, Italy. veroux@mbox.unict.it

Minerva Chirurgica
|September 5, 2003
PubMed
Abstract

Insights

Free peritoneal perforation is a rare complication of Crohn's disease. Surgical resection of the involved bowel is the recommended treatment, avoiding simple sutures, with no observed mortality in this study.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Inflammatory Bowel Disease

Background:

  • Free peritoneal perforation is an infrequent complication of Crohn's disease.
  • Crohn's disease management often involves surgical intervention.
  • Perforation necessitates prompt and appropriate surgical care.

Purpose of the Study:

  • To evaluate the incidence of free peritoneal perforation in surgically treated Crohn's disease patients.
  • To analyze the clinical presentation and outcomes of perforation.
  • To determine optimal surgical management strategies.

Main Methods:

  • Retrospective analysis of 208 patients with Crohn's disease undergoing surgery between 1992 and 2000.
  • Identification of patients with free peritoneal perforation.
  • Review of surgical procedures and patient outcomes.

Main Results:

  • Five patients (2.4%) experienced free peritoneal perforation.
  • Perforations occurred in both small (3 cases) and large bowel (2 cases).
  • All patients underwent bowel resection; two required ileostomy; no mortality or major complications were observed.

Conclusions:

  • Free peritoneal perforation is a rare but serious complication of Crohn's disease.
  • Surgical resection of the involved bowel is mandatory; simple suture repair is not recommended.
  • Immediate or delayed anastomosis following resection is the preferred surgical approach, depending on sepsis severity.

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