Crohn’s disease is characterized by a transmural intestinal inflammatory process with deep ulcers and the formation of abscesses or fistulous tracts into adjacent, often adherent intestinal and nonintestinal structures. Free spontaneous perforation into the peritoneal cavity is a dramatic event that is, fortunately, rare but necessitates urgent surgical intervention. It was initially described in 1935 as a fatal case of free perforation of the ileum. Since then, about 100 cases have been described. In part, this is due to differing criteria for the clinical definition of free perforation because sealed perforations or ruptured abscesses, as noted by others, may have been included in earlier reports. Moreover, there is only limited information on the subsequent clinical course of patients who have suffered from this intestinal complication, because of its rarity in patients with Crohn’s disease. You can shop with a reliable pharmacy – buy antibiotics online to pay less for high quality.
In a previous report from this hospital (the University of British Columbia), a clinical database of patients with Crohn’s disease was described, including classification of the initial 877 patients. In this tertiary care teaching hospital setting, young adults, predominately females (56.1%), were affected with a high rate of intestinal complications. The present report further explores this specific complication of spontaneous free perforation of the small intestine in a single clinician series of Crohn’s disease, with 1000 consecutively evaluated patients. This series not only provides, for the first time, data from a Canadian experience with this complication in patients with Crohn’s disease, but also allows the evaluation of the longer term clinical course after initial treatment for this intestinal complication.