Acute free perforation as a presenting sign of regional enteritis. Case report and collective review of the literature.

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