Janevicius R V, Bartolome J S, Schmitz R L
Am J Gastroenterol. 1980 Aug;74(2):143-9.
Regional enteritis rarely presents as free peritoneal perforation. A case of such a manifestation is described and the literature is reviewed. Resection of the diseased segment is mandatory, for it is associated with the least postoperative morbidity and mortality. Satisfactory results are achieved with cutaneous double-barrel ileotransverse colostomy and subsequent reanastomosis or closure but primary anastomosis can be accomplished safely with construction of a "T-vent" (cutaneous transverse colostomy with ileotransverse colostomy). Perforation of an area of regional enteritis, although uncommon, should be considered in the differential diagnosis of the acute abdomen with peritonitis
局限性肠炎很少表现为游离性腹膜穿孔。本文描述了一例这种表现的病例并对相关文献进行了综述。切除病变肠段是必要的，因为它与术后最低的发病率和死亡率相关。采用皮肤双腔回肠横结肠造口术及随后的再吻合或关闭可取得满意效果，但通过构建“T型造口”（皮肤横结肠造口术加回肠横结肠造口术）可安全地完成一期吻合。局限性肠炎区域的穿孔虽然不常见，但在伴有腹膜炎的急腹症鉴别诊断中应予以考虑。
