Spontaneous free perforation of the distal ileum in Crohn's disease: case study.

Free perforation of the intestine in Crohn's disease is an uncommon occurrence, with an incidence of 1% to 3% in Western countries. This report describes a case of free perforation of the distal ileum caused by Crohn's disease, in which resection and primary anastomosis was performed. The medical records of the case were reviewed. The patient presented acutely with free perforation of the distal ileum secondary to previously undiagnosed Crohn's disease. Postoperatively 13 days, the patient's course was complicated by anastomotic leakage and abscess formation. After drainage, subtotal colectomy, and re-anastomosis, primary abdominal closure was achieved using collagen matrix derived from porcine dermis. Resection and primary anastomosis is widely considered the preferred treatment for perforated small bowel. This case describes the successful treatment of an associated anastomotic complication that uses porcine dermal collagen to achieve primary closure and rapid recovery.