An 84-year-old woman who had been followed for Crohn s Disease was admitted due to lower abdominal pain and a fever. A CT scan on admission showed a thickened wall of the terminal ileum, and extraluminal air in the mesenterium. A subsequent CT scan revealed ileal penetration due to a Press Through Package (PTP), and we performed ileocecal resection. The patient had a good postoperative course. This is the first report of patient penetration or perforation by PTP with Crohn s Disease, and we report this case and review the relevant literature. Although this is a rare cause of intestinal perforation, multi-planar exams using MDCT may help precise diagnosis, especially in elderly patients with intestinal stenosis.
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