Perforated Diverticulitis of the Terminal Ileum Complicating Crohns Disease with Chronic Renal Failure 第36巻02号0175頁

Received: January 18, 2011/Accepted: February 5, 2011 Correspondence to: Kenji Hibi Department of Gastroenterological Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aobaku, Yokohama, Kanagawa 227-8501, Japan Abstract In Crohn’s disease (CD), active terminal ileitis may expand to the diverticulum but usually does not impact on clinical decision-making. We detail an original surgical approach in a woman with perforated diverticulitis and CD. Case presentation We report the case of a 53-year-old woman with chronic renal failure admitted for lower right abdominal pain, fever, and an abdominal abscess. Computed tomography (CT) showed active ileocecal inflammation and fluid collecting in the right iliac fossa suggesting intestinal perforation. In addition to localized ileitis and ileocecal colitis, ileocaecal resection for diverticulitis perforation showed a 3×3 cm abscess. Pathologically, the surgical specimen showed transmural inflammation with granulomas and perforation of the end of the diverticulum. Conclusion CD of the ileum may result in intestinal diverticulitis and perforation.