The American Journal of Digestive Diseases

, Volume 13, Issue 3, pp 275–283 | Cite as

Free perforation in regional enteritis

  • James Kyle
  • Taki Caridis
  • Thomas Duncan
  • Stanley W. B. Ewen
Article

Summary

1. Free perforation is a not infrequent complication of regional enteritis; 95 cases have now been recorded. It can occur in any age group and at any stage in the disease.

2. Perforations may be multiple and can occur in the jejunum and cecum as well as at the common site in the lower ileum. Drugs do not appear to play any part in their etiology; thrombosis of intramural vessels may be important.

3. The clinical picture is the classic one of perforation of the alimentary tract, with profound circulatory collapse.

4. Early surgery is essential, with either simple suture of the perforation or emergency resection when conditions are favorable.

Keywords

Public Health Regional Enteritis Perforation Clinical Picture Common Site 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Crohn, B. B. Acute regional ileitis. Clinical aspects and follow-up studies.New York J Med 65:641, 1965.PubMedGoogle Scholar
  2. 2.
    Crohn, B. B. Indication for surgical intervention in regional ileitis.Arch Surg 74:305, 1957.Google Scholar
  3. 3.
    Arnheim, H. L., andLee, W. E. Regional ileitis with perforation, abscess and peritonitis.J Mount Sinai Hosp NY 2:61, 1935.Google Scholar
  4. 4.
    Cumming, R. P. Acute perforation in regional ileitis.J Roy Coll Surg Edinb 7:147, 1962.Google Scholar
  5. 5.
    Fischmann, M. Crohn's ileocolitis with free perforation.Prensa Med Argent 52:2116, 1965.PubMedGoogle Scholar
  6. 6.
    Kalev, N. Case of regional enteritis complicated by free perforation.Khirurgiia (Sofia) 15:949, 1962.PubMedGoogle Scholar
  7. 7.
    Kyle, J., andBlair, D. W. Epidemiology of regional enteritis in N.E. Scotland.Brit J Surg 52:215, 1965.PubMedGoogle Scholar
  8. 8.
    Crismer, R., andDreze, C. Perforation into the peritoneal cavity in Crohn's disease.Arch Mal Appar Dig 53:570, 1964.PubMedGoogle Scholar
  9. 9.
    Linden, L. W. F. Perforating acute terminal ileitis.Ann Chir Gynaec Fenn 47:362, 1958.PubMedGoogle Scholar
  10. 10.
    Yovanovitch, M. B. Y. The place and the possibility of surgery in Crohn's disease.Arch Mal Appar Dig 50:1062, 1961.PubMedGoogle Scholar
  11. 11.
    Armitage, G., andWilson, M. Crohn's Disease. A survey of the literature and report on 34 cases.Brit J Surg 38:182, 1950.PubMedGoogle Scholar
  12. 12.
    Lojacono, F. A case of perforated sclero-ulcerous chronic segmental enteritis.Arch Ital Mal Appar Dig 30:56, 1963.Google Scholar
  13. 13.
    Rampal, M. Perforated terminal ileitis.Marseille Chir 15:129, 1963.Google Scholar
  14. 14.
    Homb, A. On acute regional enteritis.Acta Chir Scand 94:343, 1946.Google Scholar
  15. 15.
    Jackson, B. B. Chronic regional enteritis.Ann Surg 148:81, 1958.PubMedGoogle Scholar
  16. 16.
    Daffner, J. E., andBrown, C. H. Regional enteritis. I. Clinical aspects and diagnosis in 100 patients.Ann Intern Med 49:580, 1958.PubMedGoogle Scholar
  17. 17.
    Melassonos, J. S., andSmith, E. B. Small bowel perforation in regional enteritis secondary to administration of steroids.J Nat Med Ass 52:171, 1960.Google Scholar
  18. 18.
    Greene, J. M., Soronsky, S., Zackler, J., andGreene, E. L. Perforation of regional enteritis into the free peritoneal cavity.Illinois Med J 121:50, 1962.Google Scholar
  19. 19.
    Loblovics, I., andBesznyak, I. Perforating regional ileitis.Orv Hetil 103:1461, 1962.PubMedGoogle Scholar
  20. 20.
    Crohn, B. B. The pathology of acute regional ileitis.Amer J Dig Dis 10:565, 1965.CrossRefPubMedGoogle Scholar
  21. 21.
    Harjola, P. T., Appelqvist, R., andLilios, H. G. Small bowel perforation in Crohn's disease.Acta Chir Scand 130:143, 1965.PubMedGoogle Scholar
  22. 22.
    Altman, A. D., Golden, D., Seidenberg, B., Kavee, D., andParker, J. G. Free perforation in regional enteritis.Amer J Dig Dis 11:658, 1966.CrossRefPubMedGoogle Scholar
  23. 23.
    Robinson, K. P., andCraft, J. L. Free perforation of the small bowel due to regional enteritis.Brit J Surg 54:799, 1967.PubMedGoogle Scholar
  24. 24.
    Lavelle, E. F. Free perforation and plasma protein depletion in regional enteritis.Brit J Surg 51:343, 1964.PubMedGoogle Scholar
  25. 25.
    Mazal, V. Acute perforating regional ileitis.Rozhl Chir 43:726, 1964.PubMedGoogle Scholar
  26. 26.
    Khadzhakov, A. K. Perforation of small intestine in Crohn's disease.Vestin Khir Grekov 94:122, 1965.Google Scholar
  27. 27.
    Krasermann, P. H. Free perforation in acute terminal ileitis.Zbl Chir 90:593, 1965.PubMedGoogle Scholar
  28. 28.
    Gerst, P. H., Porter, M. R., andFishman, R. A. Symptomatic magnesium deficiency in surgical patients.Ann Surg 159:402, 1964.PubMedGoogle Scholar
  29. 29.
    Krause, U. Regional enterocolitis.Svensk Lak 61:2130, 1964.Google Scholar
  30. 30.
    Mark, F. W. Incidental appendectomy with regional enteritis.Arch Surg (Chicago) 88:546, 1964.PubMedGoogle Scholar
  31. 31.
    Sewel, J. H. Acute perforation of the small intestine in regional enteritis.Amer J Gastroent 47:148, 1967.PubMedGoogle Scholar
  32. 32.
    Yamase, K. Free perforation of regional enteritis.Int Surg 45:29, 1966.PubMedGoogle Scholar
  33. 33.
    Van Heerden, J. A., Sigler, R. M., andLynn, H. B. Regional enteritis in children: surgical aspects.Proc Mayo Clin 42:100, 1967.PubMedGoogle Scholar
  34. 34.
    Cornell, A., andTolins, P. G. Free perforation occurring in granulomatous colitis. 3rd World Congress of Gastroenterology, Tokyo, 1966.Google Scholar
  35. 35.
    Janowitz, H. D., Lindner, A. E., andMarshak, R. H. Granulomatous colitis: Crohn's disease of the colon.JAMA 191:825, 1965.PubMedGoogle Scholar
  36. 36.
    Hawk, W. A., andTurnbull, R. B. Primary ulcerative disease of the colon.Gastroenterology 51:802, 1966.PubMedGoogle Scholar
  37. 37.
    Sparberg, M., andKirsner, J. B. Long term corticosteroid therapy for regional enteritis.Amer J Dig Dis 11:865, 1966.CrossRefPubMedGoogle Scholar
  38. 38.
    Barber, K. W., Waugh, J. M., Beahrs, O. H., andSauer, W. G. Indications for and results of the surgical treatment of regional enteritis.Ann Surg 156:472, 1962.Google Scholar
  39. 39.
    Colcock, B. P., andFortin, C. Surgical treatment of regional enteritis.Ann Surg 161:812, 1965.PubMedGoogle Scholar
  40. 40.
    Edwards, H. Crohn's disease.J Roy Coll Surg Edinb 9:115, 1964.Google Scholar
  41. 41.
    Murray, I., andEdwards, H. Personal communication.Google Scholar
  42. 42.
    Schofield, P. F. The natural history and treatment of Crohn's disease.Ann Roy Coll Surg Eng 36:258, 1965.PubMedGoogle Scholar
  43. 43.
    Morgagni, J. B. The Seats and Causes of Diseases Investigated by Anatomy (Vol. 2), Alexander, B., Transl. Millar, Cadell, Johnson and Payne, London, 1769, p. 64.Google Scholar
  44. 44.
    McHardy, G. Regional enteritis.Texas J Med 57:365, 1961.Google Scholar
  45. 45.
    Neely, J. C. Perforation in regional enteritis.JAMA 174:1680, 1960.PubMedGoogle Scholar
  46. 46.
    Williams, W. J. Histology of Crohn's syndrome.Gut 5:510, 1964.Google Scholar
  47. 47.
    Lockhart-Mummery, H. E., andMorson, B. C. Crohn's disease of the large intestine.Gut 5:493, 1964.Google Scholar
  48. 48.
    Kyle, J. Surgery of regional enteritis.Aust New Zeal J Surg 34:116, 1964.PubMedGoogle Scholar
  49. 49.
    Buckley, J. J., Seiden, S. P., Jiminez, F. A., andKaufman, G. Enteritis gravis. Report of three cases.Gastroenterology 42:330, 1962.PubMedGoogle Scholar
  50. 50.
    Campbell, J. R., andKnapp, R. W. Small bowel ulceration associated with thiazide and potassium therapy.Ann Surg 163:291, 1966.PubMedGoogle Scholar

Copyright information

© Hoeber Medical Division • Harper & Row, Publishers, Incorporated 1968

Authors and Affiliations

  • James Kyle
    • 1
  • Taki Caridis
    • 1
  • Thomas Duncan
    • 1
  • Stanley W. B. Ewen
    • 1
  1. 1.From the Departments of Surgery and PathologyUniversity of Aberdeen and the Royal InfirmaryAberdeenScotland

Personalised recommendations