Abstract
We report a rare case wherein idiopathic perforation of the small intestine occurred twice in 7 years. A 39-year-old man had a surgical history of closure of perforation of the small intestine due to small intestinal perforation of unknown cause when he was 32 years old and partial resection of the small intestine due to strangulation ileus when he was 33 years old. He complained of abdominal pain after eating lunch, and visited our hospital. He had tenderness throughout the abdomen. An abdominal CT scan revealed ascites without free air. Emergency surgery was performed based on the diagnosis of diffuse peritonitis. At the time of laparotomy, a 10-mm perforation of the small intestine was confirmed, and partial resection of the small intestine was performed. His postoperative course was uneventful. Histopathologically, the mucosa, muscular, and serous layers at the perforation had ruptured, but no special lesions suggestive of chronic inflammation were seen around the lesion. There were no other pathological findings. Therefore, he was diagnosed with idiopathic perforation of the small intestine. The histopathological findings of the specimen from the previous perforation were almost the same as those for the present perforation. Therefore, the previous perforation was also diagnosed as idiopathic perforation.
