Crohn's Disease Diagnosed Intraoperatively During a Trauma Exploratory Laparotomy.

Area of Science:

• Gastroenterology
• Trauma Surgery
• Inflammatory Bowel Disease

Background:

• Crohn's disease is a chronic inflammatory bowel disease.
• It typically presents with abdominal pain, diarrhea, and weight loss.
• Incidental discovery during emergent trauma surgery is rare.

Purpose of the Study:

• To report a rare case of Crohn's disease incidentally discovered during trauma surgery.
• To highlight the diagnostic challenges and management complexities.
• To emphasize the importance of a broad diagnostic perspective in emergent settings.

Main Methods:

• Case report of a 25-year-old male with blunt abdominal trauma.
• Exploratory laparotomy revealing signs of undiagnosed Crohn's disease.
• Multidisciplinary team approach for management of acute injuries and chronic condition.

Main Results:

• Exploratory laparotomy revealed "creeping fat," adhesions, and an enterocolonic fistula, suggesting Crohn's disease.
• Patient required extended small bowel resection and developed postoperative complications including abscesses and pleural effusions.
• Final pathology confirmed multifocal colonic ulceration, ileocolic fistula, and perforation consistent with Crohn's disease.

Conclusions:

• Unrecognized inflammatory bowel disease can complicate trauma surgery recovery.
• Early suspicion and tailored interventions are crucial for mitigating complications.
• Vigilance for atypical findings in emergent settings improves patient outcomes.