A case of crohn's disease associated with carcinoma of the ileum, found after surgery for peritonitis

Abstract

A male in his 50's was diagnosed with Crohn's disease (ileocolitis) 11 years prior to admission for an intra-abdominal abscess. He improved on conservative therapy, but 2 months later developed sudden abdominal pain and a high fever. Given a diagnosis of pan-peritonitis, an emergency operation was done, and a perforated ileum without tumor-related changes was found. The stenotic and perforated part of the ileum was resected. On histopathology of the resected ileum, a moderately differentiated tubular adenocarcinoma, which invaded the subserosa around the perforation was found. The patient died 21 months after operation due to recurrence.
In Japan, only 28 cases of Crohn's disease complicated by carcinoma of the ileum have been reported up to 2008. However, with the increasing number of patients with Crohn's disease, there is a possibility of an increase in the number of Crohn's cases with carcinoma of the ileum.