A Case of Crohn's Disease Detected after Traumatic Perforation of the Small Intestine

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  • 外傷性小腸穿孔を契機に発見されたCrohn病の1例
  • 症例 外傷性小腸穿孔を契機に発見されたCrohn病の1例
  • ショウレイ ガイショウセイ ショウチョウ センコウ オ ケイキ ニ ハッケン サレタ Crohnビョウ ノ 1レイ

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Abstract

A 39-year-old man sustained an injury to his lower abdomen by hitting it on an iron bar while teaching uphill cycling to his son. Initially, the pain subsided. However, he developed lower abdominal pain and began vomiting after dinner, and visited a neighborhood hospital. He was admitted to the hospital for observation, and developed a high fever the next morning. Abdominal computed tomography revealed free air in his abdomen. He was transferred to our hospital and diagnosed with perforation of the digestive tract. We found edema of the distal ileum and thickened mesentery tissue, and performed partial resection of the ileum. The resected specimen revealed a longitudinal ulcer and histopathological examination revealed epithelioid cell granuloma and inflammatory cell infiltration into all layers of the intestinal wall. We diagnosed the patient with Crohn's disease.<BR>Patients with Crohn's disease are likely to develop perforation of the intestinal tract from mild blunt abdominal trauma. Although it is rare, Crohn's disease should be considered in patients with perforation of the intestinal tract by mild blunt abdominal trauma.

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