Napolitano L, de Nicola P, Di Bartolomeo N, Aceto L, Liddo G, Angelucci D, Innocenti P
Dipartimento di Scienze Chirurgiche, Ospedale SS. Annunziata, Università degli Studi di Chieti.
G Chir. 2005 May;26(5):212-4.
A case of perforated small bowel adenocarcinoma presenting as first symptom of Crohn's disease is reported in a 53 years old male patient with abdominal pain and alteration of bowel habits. Endoscopic bioptical sampling demonstrated a Crohn's disease in active stage. The patient underwent medical therapy with resolution of the complained symptomatology; 20 days after discharge the patients is rehospitalized for acute abdomen. A narrowing perforated neoplasia in terminal ileum was discovered at laparotomy. Diffuse peritonitis and metastatic peritoneal implantations were also revealed. An ileocolic resection is performed with ileo-transverse colon anastomosis. The patient dies 4 months later for advanced disease.
报道了一例53岁男性患者，以腹痛和排便习惯改变为首发症状，最初诊断为克罗恩病，后发现是小肠腺癌穿孔。内镜活检显示处于活动期的克罗恩病。患者接受药物治疗后症状缓解；出院20天后因急腹症再次住院。剖腹探查发现回肠末端有一狭窄穿孔性肿瘤，还发现弥漫性腹膜炎和转移性腹膜种植。行回结肠切除术并进行回肠-横结肠吻合术。患者4个月后因疾病进展死亡。
