Abstract
A 25-year-old man with a 2-year history of Crohn's disease visited our emergency room complaining of abdominal pain 6 hours after a traffic accident. Signs of peritoneal irritation were recognized over the entire abdomen, and a chest x-ray revealed the presence of free air in the subphrenic space. Abdominal contrast-enhanced CT revealed free air and a fluid collection at the surface of the liver. More free air was found in the mesenteric fat tissue of the small intestine. We performed emergency surgery under the diagnosis of perforation of the small intestine. Partial resection of the perforated small intestine was performed. The resected specimen revealed a longitudinal ulcer compatible with Crohn's disease and a perforation along the ulcer. An abrupt increase of the intraluminal pressure due to blunt abdominal trauma was assumed to have been the cause of this perforation. Patients with Crohn's disease may be at a higher risk of developing traumatic intestinal perforation.
