Abstract
We report herein the case of a 23-year-old man with Crohn's disease who was found to have a perforated small bowel following blunt abdominal trauma sustained in a traffic accident. The general findings of diffuse peritonitis were identified by physical examination, and a plain X-ray film showed free air in the abdominal cavity. An emergency laparotomy was performed which revealed three perforated ulcers in the affected intestine. An abrupt increase in intraluminal pressure due to the striking force of the steering wheel to the abdomen was assumed to have been the cause of these perforations.
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References
Farmer RG, Hawk WA, Turnbull RB (1976) Indications for surgery in Crohn's disease. Gastroenterology 71:245–250
Greenstein AJ, Mann D, Heimann T, Sachar DB, Lachman P, Aufses AH (1987) Spontaneous free perforation and perforated abscess in 30 patients with Crohn's disease. Ann Surg 205:72–76
Steinberg DM, Cooke WT, Williams JA (1973) Free perforation in Crohn's disease. Gut 14:187–190
Horie Y, Chiba M, Kodama K, Iizuka M, Itoh R, Masamune O, Asanuma M (1990) Ileal perforation in Crohn's disease (in Japanese with English abstract). Nippon Daicho Koumon Byo Gakkai Zasshi (J Jpn Soc Colo-Proctol) 43:455–460
Ikeda H, Isomatu T, Sugii S, Takagi R, Kozasa S, Minase S (1990) A case of perforated Crohn's disease of the small intestine and review of the cases in Japan (in Japanese). Geka 52:312–316
Katsumata T, Yamamoto Y, Igarashi M, Akima R, Okabe H, Shimazu S, Takahashi T, Atari H (1983) Crohn's disease with complications of free perforation of the ileum (in Japanese with English abstract). I to Cho (Stom Intest) 18:1279–1292
Kyle J, Caridis T, Duncan T, Ewen SWB (1968) Free perforation in regional enteritis. Am J Dig Dis 13:275–283
Nagasako K, Hasegawa K, Tanabe M, Akimoto A, Hamano K (1983) Morphology and clinical symptoms of Crohn's disease (in Japanese with English abstract). I to Cho (Stom Intest) 18:1279–1292
Okai H, Miho O, Suzuki H, Shioiri N, Chiba H (1986) Perforation of the colon and rectum (in Japanese). Hukubu Kyukyu no Shinpo 6:619–623
Johnson GA, Baker J (1990) Colonic perforation following mild trauma in a patient with Crohn's disease. Am J Emerg Med 8:340–341
Donohue JH, Crass RA, Trunkey DD (1985) The management of duodenal and other small intestinal trauma. World J Surg 9:904–913
Robbs JV, Moore SW, Pillay SP (1980) Blunt abdominal trauma with jejunal injury. J Trauma 20:308–311
Shimazu H (1987) Suture and anastomosis of the duodenum, small intestine, colon, and rectum (in Japanese). In: Kusama S, Wada T, Saegusa M (eds) Geka Mook 4, Tokyo, pp 181–201
Kitano M, Yamamoto S, Mogi M, Yoshii H, Uchida T, Ohtomo Y, Mikaya S, Hayakawa K, Sudo M (1987) Traumatic rupture of digestive tract (in Japanese). Rinshyogeka 42:299–305
Torikoshi T, Kunisaki T, Sugamura Y, Ishibashi M, Nakao H, Nagayasu T, Ide S, Tominaga T, Sekine I (1990) Clinical study of non-traumatic rupture of the small intestine (in Japanese). Rinshyo to Kenkyu 67:141–144
Fazio VW (1983) Regional enteritis (Crohn's disease). Surg Clin North Am 63:27–48
Post S, Betzler M, Ditfurth B, Schurmann G, Kuppers P, Herfarth C (1991) Risks of intestinal anastomoses in Crohn's disease. Ann Surg 213:37–42
Voller G, Britt L (1990) Surgical management of perforated Crohn's disease. Ann Surg 56:100–103
Heimann T, Greenstein AJ, Mechanic L, Aufses AH (1985) Early complications following surgical treatment of Crohn's disease. Ann Surg 201:494–498
Greenstein AJ, Lachman P, Sacher DB, Springhorn J, Heimann T, Janowitz HD, Aufses AH (1988) Perforating and non-perforating indications for repeated operations in Crohn's disease. Gut 29:588–592
Hulten L (1988) Surgical treatment of Crohn's disease of the small bowel or ileocecum. World J Surg 12:180–185
Mutoh T, Konishi H, Sawada T (1985) Non-specific inflammatory bowel disease (in Japanese). Shindan to Chiryo 73:1188–1191
Shiratori T, Nakano H, Inatsugi N, Matsutani K, Hujii H, Murakami K (1985) Surgical treatment of Crohn's disease and ulcerative colitis (in Japanese). Geka Shinryo 27:567–574
Okies JE, Bricker DL, Jordan GL, Beall AC, DeBakey ME (1972) Exteriorized primary repair of colon injuries. Am J Surg 124:807–810
Nadkarni KM, Shetty SD, Kagzi RS, Pinto AC, Bhalerao RA (1981) Small-bowel perforations. Arch Surg 116:53–57
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Tomita, H., Hojo, I., Yasuda, S. et al. Jejunal perforation caused by blunt abdominal trauma in a patient with Crohn's disease: Report of a case. Surg Today 23, 1099–1102 (1993). https://doi.org/10.1007/BF00309102
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DOI: https://doi.org/10.1007/BF00309102