Differences in pathogenesis, incidence and outcome of perforation in inflammatory bowel disease
Greenstein, A.J.; Aufses, A.H.
Surgery Gynecology and Obstetrics 160(1): 63-69
1985
ISSN/ISBN: 0039-6087 PMID: 3871126 Document Number: 254940
The patient records of 49 of 1623 patients in whom perforation occurred during the course of inflammatory intestinal disease were studied. Perforation occurred most commonly with toxic megacolon in UC , 1.8%). Mortality was no different in toxic megacolon in patients with UC compared with those with Crohn's disease or in patients with UC with free perforation compared with those with sealed perforation. Mortality was significantly greater in patients with perforation in UC than in those with Crohn's disease in the absence of toxic megacolon. All 15 patients with spontaneous free perforation in Crohn's disease treated by resection or exteriorization with diversion survived compared with 4 of 7 deaths of free perforation in UC. There is no explanation for the remarkable difference in survival of free perforation in the absence of toxic megacolon in UC and CD, but it may be due to differing immunologic states or pathogenetic mechanisms.