Perforated Crohn's disease presenting during pregnancy
Severe exacerbations of Crohn's disease (CD) requiring acute surgery are rare, and rarer still are those that occur during pregnancy. We present a case of perforated CD in an obstetric patient. A 24-year-old woman at 27 weeks gestation, with abdominal pain, leucocytosis and concern for preterm...
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| Veröffentlicht in: | BMJ case reports 2015-10, Vol.2015, p.bcr2015210109 |
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| creator | Burgers, Jessica Ruiz, Oscar Rivers, Jose |
| description | Severe exacerbations of Crohn's disease (CD) requiring acute surgery are rare, and rarer still are those that occur during pregnancy. We present a case of perforated CD in an obstetric patient. A 24-year-old woman at 27 weeks gestation, with abdominal pain, leucocytosis and concern for preterm labour, presented to our institution. MRI was obtained and demonstrated a phlegmon in the small bowel mesentery near the distal ileum, with concern for perforation. The patient was taken for an emergent exploratory laparotomy. Intraoperatively, an ileal perforation with small bowel fistula was observed and an ileocolectomy with primary anastomosis was performed. Pathology of the resection revealed CD, a new diagnosis for the patient. She was ultimately discharged on postoperative day 13 and later went on to deliver a healthy term infant, and, 5 years later, has had no significant recurrence. |
| doi_str_mv | 10.1136/bcr-2015-210109 |
| format | Article |
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We present a case of perforated CD in an obstetric patient. A 24-year-old woman at 27 weeks gestation, with abdominal pain, leucocytosis and concern for preterm labour, presented to our institution. MRI was obtained and demonstrated a phlegmon in the small bowel mesentery near the distal ileum, with concern for perforation. The patient was taken for an emergent exploratory laparotomy. Intraoperatively, an ileal perforation with small bowel fistula was observed and an ileocolectomy with primary anastomosis was performed. Pathology of the resection revealed CD, a new diagnosis for the patient. She was ultimately discharged on postoperative day 13 and later went on to deliver a healthy term infant, and, 5 years later, has had no significant recurrence.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2015-210109</identifier><identifier>PMID: 26452410</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Abdomen ; Abscesses ; Amniocentesis ; Anastomosis, Surgical ; Cholecystectomy ; Colectomy - methods ; Crohn Disease - diagnosis ; Crohn Disease - pathology ; Crohn's disease ; Female ; Fistula ; Gallbladder diseases ; Humans ; Ileum - surgery ; Inflammation ; Inflammatory bowel disease ; Intestinal Fistula - surgery ; Intestinal Perforation - surgery ; Laparotomy ; Magnetic Resonance Imaging ; Obstetrics ; Pain ; Patients ; Pregnancy ; Pregnancy Complications - surgery ; Surgery ; Unusual Presentation of More Common Disease/Injury ; USA/Canada ; White ; Womens health ; Young Adult</subject><ispartof>BMJ case reports, 2015-10, Vol.2015, p.bcr2015210109</ispartof><rights>2015 BMJ Publishing Group Ltd</rights><rights>2015 BMJ Publishing Group Ltd.</rights><rights>Copyright: 2015 2015 BMJ Publishing Group Ltd</rights><rights>2015 BMJ Publishing Group Ltd 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-b3259-42939c5181f5aeb299079d0398a530402465753ad1c11024850ff1f6542b5c8c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600773/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600773/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26452410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Burgers, Jessica</creatorcontrib><creatorcontrib>Ruiz, Oscar</creatorcontrib><creatorcontrib>Rivers, Jose</creatorcontrib><title>Perforated Crohn's disease presenting during pregnancy</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>Severe exacerbations of Crohn's disease (CD) requiring acute surgery are rare, and rarer still are those that occur during pregnancy. We present a case of perforated CD in an obstetric patient. A 24-year-old woman at 27 weeks gestation, with abdominal pain, leucocytosis and concern for preterm labour, presented to our institution. MRI was obtained and demonstrated a phlegmon in the small bowel mesentery near the distal ileum, with concern for perforation. The patient was taken for an emergent exploratory laparotomy. Intraoperatively, an ileal perforation with small bowel fistula was observed and an ileocolectomy with primary anastomosis was performed. Pathology of the resection revealed CD, a new diagnosis for the patient. She was ultimately discharged on postoperative day 13 and later went on to deliver a healthy term infant, and, 5 years later, has had no significant recurrence.</description><subject>Abdomen</subject><subject>Abscesses</subject><subject>Amniocentesis</subject><subject>Anastomosis, Surgical</subject><subject>Cholecystectomy</subject><subject>Colectomy - methods</subject><subject>Crohn Disease - diagnosis</subject><subject>Crohn Disease - pathology</subject><subject>Crohn's disease</subject><subject>Female</subject><subject>Fistula</subject><subject>Gallbladder diseases</subject><subject>Humans</subject><subject>Ileum - surgery</subject><subject>Inflammation</subject><subject>Inflammatory bowel disease</subject><subject>Intestinal Fistula - surgery</subject><subject>Intestinal Perforation - surgery</subject><subject>Laparotomy</subject><subject>Magnetic Resonance Imaging</subject><subject>Obstetrics</subject><subject>Pain</subject><subject>Patients</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - surgery</subject><subject>Surgery</subject><subject>Unusual Presentation of More Common Disease/Injury</subject><subject>USA/Canada</subject><subject>White</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkctLAzEQh4MoVrRnb7LgQRFWZ_LYbC6CFF8g6EHBW8hms3XLdrcmXaH_vamtRb2Yy-Tx5WOGHyGHCOeILLsorE8poEgpAoLaInsohUylgtftH_sBGYYwgbgY8pyzXTKgGReUI-yR7Mn5qvNm7spk5Lu39iQkZR2cCS6ZeRdcO6_bcVL2flnizbg1rV0ckJ3KNMEN13WfvNxcP4_u0ofH2_vR1UNaMCpUyqliygrMsRLGFVQpkKoEpnIjGHCgPBNSMFOiRYynXEBVYZUJTgthc8v2yeXKO-uLqSttbMebRs98PTV-oTtT698vbf2mx92H5hmAlCwKTtcC3733Lsz1tA7WNY1pXdcHjZJSzIUEGdHjP-ik630bx9OYR19G4Ut4saKs70Lwrto0g6CXsegYi17GolexxB9HP2fY8N8hROBsBRTTyb-2T_y-k1g</recordid><startdate>20151008</startdate><enddate>20151008</enddate><creator>Burgers, Jessica</creator><creator>Ruiz, Oscar</creator><creator>Rivers, Jose</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20151008</creationdate><title>Perforated Crohn's disease presenting during pregnancy</title><author>Burgers, Jessica ; Ruiz, Oscar ; Rivers, Jose</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b3259-42939c5181f5aeb299079d0398a530402465753ad1c11024850ff1f6542b5c8c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Abdomen</topic><topic>Abscesses</topic><topic>Amniocentesis</topic><topic>Anastomosis, Surgical</topic><topic>Cholecystectomy</topic><topic>Colectomy - methods</topic><topic>Crohn Disease - diagnosis</topic><topic>Crohn Disease - pathology</topic><topic>Crohn's disease</topic><topic>Female</topic><topic>Fistula</topic><topic>Gallbladder diseases</topic><topic>Humans</topic><topic>Ileum - surgery</topic><topic>Inflammation</topic><topic>Inflammatory bowel disease</topic><topic>Intestinal Fistula - surgery</topic><topic>Intestinal Perforation - surgery</topic><topic>Laparotomy</topic><topic>Magnetic Resonance Imaging</topic><topic>Obstetrics</topic><topic>Pain</topic><topic>Patients</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - surgery</topic><topic>Surgery</topic><topic>Unusual Presentation of More Common Disease/Injury</topic><topic>USA/Canada</topic><topic>White</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Burgers, Jessica</creatorcontrib><creatorcontrib>Ruiz, Oscar</creatorcontrib><creatorcontrib>Rivers, Jose</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Burgers, Jessica</au><au>Ruiz, Oscar</au><au>Rivers, Jose</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perforated Crohn's disease presenting during pregnancy</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2015-10-08</date><risdate>2015</risdate><volume>2015</volume><spage>bcr2015210109</spage><pages>bcr2015210109-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>Severe exacerbations of Crohn's disease (CD) requiring acute surgery are rare, and rarer still are those that occur during pregnancy. We present a case of perforated CD in an obstetric patient. A 24-year-old woman at 27 weeks gestation, with abdominal pain, leucocytosis and concern for preterm labour, presented to our institution. MRI was obtained and demonstrated a phlegmon in the small bowel mesentery near the distal ileum, with concern for perforation. The patient was taken for an emergent exploratory laparotomy. Intraoperatively, an ileal perforation with small bowel fistula was observed and an ileocolectomy with primary anastomosis was performed. Pathology of the resection revealed CD, a new diagnosis for the patient. She was ultimately discharged on postoperative day 13 and later went on to deliver a healthy term infant, and, 5 years later, has had no significant recurrence.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>26452410</pmid><doi>10.1136/bcr-2015-210109</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Abscesses Amniocentesis Anastomosis, Surgical Cholecystectomy Colectomy - methods Crohn Disease - diagnosis Crohn Disease - pathology Crohn's disease Female Fistula Gallbladder diseases Humans Ileum - surgery Inflammation Inflammatory bowel disease Intestinal Fistula - surgery Intestinal Perforation - surgery Laparotomy Magnetic Resonance Imaging Obstetrics Pain Patients Pregnancy Pregnancy Complications - surgery Surgery Unusual Presentation of More Common Disease/Injury USA/Canada White Womens health Young Adult |
| title | Perforated Crohn's disease presenting during pregnancy |
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