A CASE OF CROHN'S DISEASE WITH PANPERITONITIS CAUSED BY ILEUM PERFORATION DEVELOPED UNTREATED 10 YEARS OR MORE AFTER THE ONSET OF THE DISEASE

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  • １０年以上未治療で経過し，回腸穿孔による汎発性腹膜炎を発症したＣｒｏｈｎ病の１例

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Abstract

A 26-year-old man, who had been diagnosed as having Crohn's disease in 1995 but had been untreated by his judgement, was admitted to our hospital because of severe abdominal pain in December 2006. The abdomen was distended with muscle guarding, and an enhanced CT scan of the abdomen showed purulent ascites and wall thickness of the ileum in the lower abdominal cavity. Emergency operation was conducted with a diagnosis of panperitonitis due to exacerbation of Crohn's disease. At laparotomy, perforation of the ileum associated with panperitonitis was observed. Partial ileal resection and drainage were conducted. In the resected specimen, there was a longitudinal ulcer and constriction. Histologically, transmural inflammation with noncaseating granulomas was revealed and Crohn's disease was confirmed. There has been no sign of recurrence for 21 months after the operation. We have recognized the necessity of periodic medical examination and appropriate treatments for Crohn's disease.

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