Fei Dai-Liang, Yu Ze, Yan Wan-Neng, Dong Jin-Liang
Department of General Surgery, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, China.
Department of Anorectum, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, China.
Front Med (Lausanne). 2025 Jul 29;12:1557305. doi: 10.3389/fmed.2025.1557305. eCollection 2025.
A 47-year-old married woman presented with abdominal discomfort, distension, and nausea following a two-day episode of constipation accompanied by reduced urine output. Upon her admission, a physical assessment indicated tachycardia and abdominal sensitivity, while imaging examinations corroborated gastrointestinal perforation along with signs of acute diffuse peritonitis. The patient had a prior history of Crohn's disease and had been off medication for over a year. The initial surgical intervention entailed bowel resection and adhesiolysis; however, postoperative complications arose, prompting a second operation due to suspected anastomotic leakage and a severe infection. In spite of these challenges, the patient received intensive care, nutritional support, and treatment for short bowel syndrome. Over span of a month, her health significantly improved, and she was ultimately discharged with ongoing management for her Crohn's disease. This case underscores the intricacies involved in addressing intestinal perforations in patients with pre-existing Crohn's disease and highlights the imperative for prompt surgical action and comprehensive postoperative care.
一名47岁的已婚女性,在经历了两天的便秘并伴有尿量减少后,出现腹部不适、腹胀和恶心症状。入院时,体格检查显示心动过速和腹部压痛,影像学检查证实存在胃肠道穿孔以及急性弥漫性腹膜炎体征。该患者既往有克罗恩病病史,且已停药一年多。最初的手术干预包括肠切除和粘连松解术;然而,术后出现了并发症,因怀疑吻合口漏和严重感染而进行了二次手术。尽管面临这些挑战,患者仍接受了重症监护、营养支持以及短肠综合征的治疗。在一个月的时间里,她的健康状况显著改善,最终出院,并继续接受克罗恩病的治疗。该病例强调了在处理已有克罗恩病患者的肠道穿孔时所涉及的复杂性,并突出了及时进行手术干预和全面术后护理的必要性。