Mrs Green (pseudo name) is a 27 year old female with known Crohn’s disease was admitted to Hospital on August 2015 post laparoscopic ileocolic resection for bowel perforation secondary to duodenal perforation consistent with Crohn’s disease.

Mrs Green (pseudo name) is a 27 year old female with known Crohn’s disease was admitted to Hospital on August 2015 post laparoscopic ileocolic resection for bowel perforation secondary to duodenal perforation consistent with Crohn’s disease. The estimated length of stay was six to seven days. Mrs Green’s diagnosis of Crohn’s disease had been established by his local gastroenterologist 14 years before this episode and she was taking immunosuppressive medications, including azathioprine. On February 2015, she complained of recurrent episodes of mild abdominal pain, constipation, and no bowel action for the past week but denied, evidence of rectal bleeding, or febrile episodes. Computed tomography (CT) scan of the abdomen/pelvis revealed contained bowel perforation secondary to duodenal perforation consistent with Crohn’s disease. During the multidisplinary team (MDT) assessment, a pattern of medication nonadherence was noted. A detailed discussion of the reasons for poor adherence revealed significant anxiety which was directly affecting her clinical care. The MDT suggested a change to infliximab for six months prior operation. She was adherent with infliximab therapy as had been recommended, resulting in sustained clinical remission of her disease. Mrs Green is widow who lives with her family, including parents, sister and son. Her parents are very supportive. Previously she was independent with activities of daily living (ADL’s). She works as a bank teller. Mrs Green has an allergy to Mushroom. She is an ex-smoker (stopped 10 yrs. ago) and occasionally drinks alcohol.

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