Spontaneous Perforation in Crohn’s Disease: A Report of Two Cases

To the Editors, Crohn’s disease (CD) is a chronic, progressive bowel disease. Early diagnosis and treatment improve the prognosis. Herein, we report 2 cases of CD that progressed to intestinal perforation. A 78-year-old man with a history of right hemicolectomy for colonic obstruction was admitted to the hospital because of abdominal pain and melena for a week. Hemoglobin was 56g/L. No obvious abnormality was identified on gastroscopy. Computed tomography (CT) revealed bowel wall thickening with lymphadenopathy. The patient was subsequently referred to our hospital for further treatment. Colonoscopy showed multiple ileal ulcers (Figure 1A). Biopsies demonstrated infiltration of inflammatory cells, granulation tissue hyperplasia, and crypt enlargement. The symptoms were relieved after conservative management. Six months later, the patient returned with abdominal pain and had lost 24 pounds of weight. Abdominal examination revealed features of peritonitis. The CT enterography indicated progressive enlargement of bowel inflammation. Colonoscopy showed marked...