2003 Volume 23 Issue 6 Pages 853-858
The aim of this study is to delineate the treatment of acute emergencies that occur in patients with Crohn'sdisease, throngh an evaluation of the outcome of the disease performed retrospectively in over 30 emergencyoperative procedures in our hospital. These included free perforation, intra-abdominal abscess, intestinalhemorrhage, and intestinal obstruction. Jejunal-ileal free perforation, hemorrhage and intestinal obstructionare best managed with segmental intestinal resection and primary anastomosis. In perforated Crohn'scolitis, we performed segmental colonic resection with fecal diversion. Treatment of intra-abdominalabscesses should initially be attempted by echo-guided or computed tomography-guided percutaneousdrainage followed by subsequent definitive resection. The patients in whom drainage of the abscess couldnot be performed needed emergency intestinal resection and fecal diversion. Controversy still exists withregard to the validity of primary anastomosis. A temporary stoma in Crohn's disease has receivedconsiderable attention, particularly if the patient is in poor general health, for example in a state of shockat the time of the operation or having undergone long term steroid treatment. The most important factorsinfluencing the outcome are the choice of the appropriate timing for surgery and the procedure performed.
