{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:43:18Z","timestamp":1768434198301,"version":"3.49.0"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T00:00:00Z","timestamp":1612483200000},"content-version":"vor","delay-in-days":35,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance<\/jats:title>\n                    <jats:p>Crohn\u2019s disease is a chronic inflammatory bowel disease with complex pathophysiology and multiple complications, some of which can be fatal. We report herein the management of an unusual case of Crohn\u2019s disease revealed by two life-threatening complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 59-year-old patient presented with an acute abdominal pain evolving for one day with a clinical presentation in favor of peritonitis by perforation of the last ileal loop and acute limb ischemia.<\/jats:p>\n                    <jats:p>At emergency laparotomy, we found a fecal peritonitis by perforation of the last ileal loop. The patient underwent an ileo-caecal resection with rifle barrel ileo-colostomy associated with embolectomy using a Fogarty catheter of the femoral artery. Pathological examination of the specimen showed an aspect consistent with an ileo-caecal Crohn's disease and blood clot embolus of the femoral artery. Postoperative course was uneventful and the patient was kept in remission with immunosuppressants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Several complications may arise during the evolution of the disease. However, Life-threatening complication scarcely inaugurate crohn\u2019s disease like in our patient. Free perforation of the small intestine in crohn\u2019s disease occurs rarely, which makes its statistical study difficult. Risk factors for perforation are still poorly identified. Patients diagnosed with crohn's disease have a higher risk of thromboembolic complications. Indeed, there is an association between the activity of the disease and thromboembolic events. In our case, the severity of the clinical presentation as well as its inaugural character are unique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The management of inaugural two uncommon acute conditions in Crohn\u2019s disease is challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2021.02.012","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T21:32:11Z","timestamp":1612906331000},"page":"105626","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Presentation with perforation of the terminal ileum and acute limb ischemia in Crohn\u2019s disease"],"prefix":"10.1097","volume":"80","author":[{"given":"Anis","family":"Haddad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Ben Mahmoud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youssef","family":"Chaker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alia","family":"Zehani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachid","family":"Ksantini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Montasser Jameleddine","family":"Kacem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R2-43-20260114","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1016\/S0140-6736(16)31711-1","article-title":"Crohn\u2019s disease","volume":"389","author":"Torres","year":"2017","journal-title":"Lancet"},{"key":"R3-43-20260114","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1097\/MIB.0000000000000727","article-title":"Medical imaging in small bowel Crohn\u2019s disease - Computer tomography enterography, magnetic resonance enterography, and ultrasound: \u201cWhich one is the best for what\u201d","volume":"22","author":"Greenup","year":"2016","journal-title":"Inflamm. Bowel Dis"},{"key":"R4-43-20260114","first-page":"38","article-title":"Free perforation in Crohn\u2019s disease: a report of 33 cases and review of literature","volume":"81","author":"Katz","year":"1986","journal-title":"Am. J. Gastroenterol"},{"key":"R6-43-20260114","first-page":"181","article-title":"Acute free perforation as first sign of Crohn\u2019s disease","volume":"77","author":"Casteleyn","year":"1978","journal-title":"Acta Chir. Belg"},{"key":"R7-43-20260114","first-page":"72","article-title":"The clinical characteristics of patients with free perforation in Korean Crohn\u2019s disease: results from the CONNECT study","volume":"205","author":"Young Seok Doh","year":"2015","journal-title":"BMC Gastroenterol"},{"key":"R9-43-20260114","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/00000658-198701000-00013","article-title":"T Heimann, and A H Aufses, greenstein1987.pdf","volume":"205","author":"Greenstein","year":"1987","journal-title":"Ann. Surg"},{"key":"R10-43-20260114","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.disamonth.2017.07.001","article-title":"A comprehensive review and update on Crohn\u2019s disease","volume":"64","author":"Gajendran","year":"2018","journal-title":"Disease-a-Month"},{"key":"R11-43-20260114","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1007\/s10620-017-4539-5","article-title":"Incidence of and risk factors for free bowel perforation in patients with Crohn\u2019s disease","volume":"62","author":"Kim","year":"2017","journal-title":"Dig. Dis. Sci"},{"key":"R12-43-20260114","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S0002-9610(02)00879-6","article-title":"Acute surgical emergencies in inflammatory bowel disease","volume":"184","author":"Berg","year":"2002","journal-title":"Am. J. Surg"},{"key":"R13-43-20260114","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/MEG.0000000000000495","article-title":"Thromboembolism as an important complication of inflammatory bowel disease","volume":"28","author":"Bollen","year":"2016","journal-title":"Eur. J. Gastroenterol. Hepatol"},{"key":"R14-43-20260114","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1002\/ibd.21334","article-title":"Thrombosis and inflammatory bowel disease: a call for improved awareness and prevention","volume":"17","author":"Zitomersky","year":"2011","journal-title":"Inflamm. 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