title: A rare surgical complication of Crohn's diseases: free peritoneal perforation.
abstract: BACKGROUND
  Free peritoneal perforation is a rare complication of Crohn's disease.
  
  
  METHODS
  We evaluated the incidence of free peritoneal perforation among 208 patients with Crohn's disease surgically treated in the period 1992-2000.
  
  
  RESULTS
  Five patients (2.4%) suffered from free peritoneal perforation. In 1 patient free peritoneal perforation was the first symptom of Crohn's disease. In 3 cases the perforation was in the small bowel and in 2 in the large bowel. All patients underwent surgery: all cases had a resection of the involved bowel and in two cases an ileostomy was performed in order to prevent severe peritonitis. We did not observed mortality or major complications.
  
  
  CONCLUSIONS
  Free peritoneal perforation is rare with about 100 cases reported in literature. No correlation seems to exist with previous corticosteroid treatment. The surgical treatment is mandatory. Simple suture should be avoided. The most appropriate treatment, whenever it is feasible, is resection of the involved bowel with immediate or, in case of severe sepsis, delayed anastomosis.
authors.affiliation: Department of Surgery and Transplantation, University Hospital, Catania, Italy. veroux@mbox.unict.it
authors.forename: M
authors.initials: M
authors.lastname: Veroux
authors.forename: I
authors.initials: I
authors.lastname: Angriman
authors.forename: C
authors.initials: C
authors.lastname: Ruffolo
authors.forename: M
authors.initials: M
authors.lastname: Barollo
authors.forename: P
authors.initials: P
authors.lastname: Veroux
authors.forename: P
authors.initials: P
authors.lastname: Caglia
authors.forename: A
authors.initials: A
authors.lastname: Sommariva
authors.forename: P
authors.initials: P
authors.lastname: Fiamingo
authors.forename: D F
authors.initials: DF
authors.lastname: D'Amico
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*