{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:26:05Z","timestamp":1777447565117,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T00:00:00Z","timestamp":1642032000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>Small bowel perforation is an uncommon but severe event in the natural history of Crohn\u2019s disease with fewer than 100 cases reported. We review Crohn\u2019s disease cases with necrotizing enteritis and share a case of a 26-year-old female who presented with a recurrent episode of small intestinal perforation. A PubMed literature review of case reports and series was conducted using keywords and combinations of \u201cCrohn\u2019s disease,\u201d \u201csmall intestine perforation,\u201d \u201csmall bowel perforation,\u201d \u201cfree perforation,\u201d \u201cregional enteritis,\u201d and \u201cnecrotizing enteritis.\u201d Data extracted included demographic data, pre- or postoperative steroid administration, medical or surgical management, and case fatality. Nineteen reports from 1935 to 2021 qualified for inclusion. There were 43 patients: 20 males and 23 females with a mean age of 36 \u00b1 15 years old. 75 total perforations were described: 56 ileal (74.6%), 15 jejunal (20.0%), 2 cecal (2.7%), and 1 small intestine non-specified (2.7%). 38 of 43 patients were managed surgically by primary repair (11), ostomy creation (21), or an anastomosis (11). Of 11 case fatalities, medical management alone was associated with higher mortality (5\/5; 100% mortality) compared to those treated surgically (6\/38; 15.8% mortality; P &lt; .001). Patient sex, disease history, acute abdomen, and pre- or postoperative steroid use did not significantly correlate with mortality. Jejunal perforation was significantly ( P = .028) associated with event mortality while ileal was not ( P = .45). Although uncommon, necrotizing enteritis should be considered in Crohn\u2019s patients who present with small intestinal perforation. These cases often require urgent surgical intervention and may progress to fulminant sepsis and fatality if not adequately treated.<\/jats:p>","DOI":"10.1177\/00031348211054521","type":"journal-article","created":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T09:07:06Z","timestamp":1642064826000},"page":"1997-2004","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Small Intestinal Perforation Secondary to Necrotizing Enteritis\u2014An Under-Recognized Complication of Crohn\u2019s Disease"],"prefix":"10.1177","volume":"89","author":[{"given":"Carlos Theodore","family":"Huerta","sequence":"first","affiliation":[{"name":"University of Miami DeWitt Daughtry Department of Surgery, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine J.","family":"Ribieras","sequence":"additional","affiliation":[{"name":"University of Miami DeWitt Daughtry Department of Surgery, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karishma","family":"Kodia","sequence":"additional","affiliation":[{"name":"University of Miami DeWitt Daughtry Department of Surgery, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Dante","family":"Yeh","sequence":"additional","affiliation":[{"name":"University of Miami DeWitt Daughtry Department of Surgery, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kerman","sequence":"additional","affiliation":[{"name":"University of Miami Department of Gastroenterology, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Byers","sequence":"additional","affiliation":[{"name":"University of Miami DeWitt Daughtry Department of Surgery, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,1,13]]},"reference":[{"issue":"61","key":"bibr1-00031348211054521","volume":"2","author":"Arnheim HL","year":"1935","journal-title":"J Mt Sinai Hosp NY"},{"key":"bibr2-00031348211054521","unstructured":"Greenstein AJ, Heimann T. Spontaneous free perforation and perforated abscess in 30 patients with Crohn\u2019s disease. 5."},{"key":"bibr3-00031348211054521","doi-asserted-by":"publisher","DOI":"10.1155\/2002\/284958"},{"issue":"1","key":"bibr4-00031348211054521","first-page":"38","volume":"81","author":"Katz S","year":"1986","journal-title":"Am J Gastroenterol"},{"key":"bibr5-00031348211054521","doi-asserted-by":"publisher","DOI":"10.1007\/s005350200172"},{"key":"bibr6-00031348211054521","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(69)80134-4"},{"key":"bibr7-00031348211054521","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4612-1396-3_28"},{"key":"bibr8-00031348211054521","doi-asserted-by":"publisher","DOI":"10.1007\/bf02233051"},{"key":"bibr9-00031348211054521","doi-asserted-by":"publisher","DOI":"10.1136\/gut.14.3.187"},{"key":"bibr10-00031348211054521","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(19)34191-5"},{"key":"bibr11-00031348211054521","unstructured":"Duncan I. 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