OPERATED CRONH'S DISEASE WITH ILEAL PERFORATION -A CASE REPORT WITH A REVIEW OF THE JAPANESE LITERATURE-

A case of Crohn's disease with ileal perforation is reported. A 24-year-old woman was admitted to the hospital because of an abdomonal pain and fever. In spite of conservative therapy, her condition had been gradually deteriorated. Small intestineal gas in abdominal X-ray films increased, and ultrasonograms revealed a lot of ascites. Gray-color pus was punctured from the Douglas' pouch. An emergency laparotomy was performed under a diagnosis of generalized peritonitis. In addition to a large amount of purulent fluid, a perforation of the small intestine was detected at a site of two meters from the ileocaecal junction. About one meter of the ileum was resected. Macroscopically, cobble stone appearance and longitudinal ulcer were observed. The histological diagnosis was Crohn's disease. This paper presents this relatively rare case together with a review of the Japanese literature.