Dimitriu Anca 1, Gheorghe C. 1
1 Department of Gastroenterology and Hepatology ,Fundeni Clinical Institute, Bucharest
Abstract
Free peritoneal perforation is a rare complication of Crohns disease. We report the c ase of a 17 years-old male patient with Ileocolonic and perianal Crohns Disease, severe ileitis nonresponsive to anti-TNF alfa medication, who underwent a laparotomy surgery for acute abdomen and was found to have ileal perforation for which segmental enterectomy with ileotransversoanastomosis was performed. The most likely hypothesis is a bowel dilatation above a stenotic area which increased the intraluminal pressure or the inflammatory changes in the blood vessels associated with enteritis possibly contributing to an ischemic cause. Due to high risk of postoperative recurrence of the disease, anti-TNF alfa thearpy was restarted at the same dose at 1 month after surgery. The patient had good early and late postoperative outcomes.