title: Emergency surgery for Crohn's disease.
abstract: BACKGROUND
  Surgery has played an essential role in the treatment of Crohn's disease. Emergency can reveal previously unknown complications whose treatment affects prognosis.
  
  
  OBJECTIVE
  Indicate the incidence of indications in emergent surgery for Crohn's disease. Specify the types of procedures performed in these cases and assess the Results of emergency surgery for Crohn's disease postoperatively,  in short , medium and long term.
  
  
  METHODS
  Retrospective analysis of collected data of 38 patients, who underwent surgical resection for Crohn's disease during a period of 19 years from 1992 to 2011 at the department of surgery in MONGI SLIM Hospital, and among them 17 patients underwent emergency surgery for Crohn's disease. In addition to socio-demographic characteristics and clinical presentations of our study population, we evaluated the indications, the type of intervention, duration of evolution preoperative and postoperative complications and overall prognosis of the disease.
  
  
  RESULTS
  Of the 38 patients with Crohn's disease requiring surgical intervention, 17/38 patients underwent emergency surgery. Crohn's disease was inaugurated by the complications requiring emergency surgery in 11 patients. The mean duration of symptoms prior to surgery was 1.5 year. The most common indication for emergency surgery was acute intestinal obstruction (n=6) followed by perforation and peritonitis (n=5). A misdiagnosis of appendicitis was found in 4 patients and a complicated severe acute colitis for undiagnosed Crohn's disease was found in 2 cases. The open conventional surgery was performed for 15 patients. Ileocolic resection was the most used intervention. There was one perioperative mortality and 5 postoperative morbidities. The mean of postoperative hospital stay was 14 days (range 4-60 days). Six patients required a second operation during the follow-up period.
  
  
  CONCLUSIONS
  The incidence of emergency surgery for Crohn's disease in our experience was high (17/38 patients), and is not as rare as the published estimates. Emergency surgical indication could be frequently the first presentation of Crohn's disease.  Acute intestinal obstruction and perforation-peritonitis were the most common indications for emergent surgery in Crohn's disease in our study.
authors: Malek
authors: M
authors: Smida
authors: Nizar
authors: N
authors: Miloudi
authors: Rania
authors: R
authors: Hefaiedh
authors: Rabaa
authors: R
authors: Zaibi
mesh_terms: D000293:Adolescent; D000328:Adult; D003092:Colitis / Q000209:etiology / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult