Ileovesical fistulas in Crohn's disease: Clinical features and therapeutic manipulations in 5 patients

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2007 (EN)
Ileovesical fistulas in Crohn's disease: Clinical features and therapeutic manipulations in 5 patients (EN)

Mastragelis, A.
Mylonaki, Maria
Fouskas, J.
Giannakoulopoulou, Eleftheria
Georgopoulos, F.
Cheracakis, P.
Varlatzidou, Alexandra
Triantafillidis, J. K.
Malgarinos, G.
Peros, G.

The aim of this study was to describe the clinical details, and diagnostic and therapeutic manipulations applied on 5 patients with Crohn's disease who developed enterovesicular fistulas during the course of the underlying inflammatory bowel disease. These patients represent a percentage of 2.4% (5 out of 206) of patients with Crohn's disease seen and followed-up in our institution during the last fifteen years. There were 3 men and 2 women aged 34, 22, 32, 46 and 49 years, respectively. Small bowel was affected in 4 and concurrently the small and large bowel in 1 patient. During diagnosis of enterovesicular fistula, Crohn's disease was active in all cases. Main symptoms included pneumaturia, fecalurea, fever, urgency, and abdominal pain. Colonoscopy did not offer significant diagnostic aid. Abdominal computed tomography and barium enema helped in one case. Cystoscopy revealed a picture compatible with cystitis in all cases and a protruding mass in one. In one case the administration of Infliximab, the chimeric antibody against tumor necrosis alpha, resulted in temporary improvement. The administration of suitable antibiotics resulted in temporary disappearance of E. coli strains from urine in all cases. All patients were finally operated on. The surgical procedure applied was detachment of the inflamed bowel loop from urinary bladder and surgical closure of the fistula in all patients, drainage of the accompanied abscess in one case and partial enterectomy with end-to-end anastomosis in two cases. It is concluded that enterovesicular fistulas are a potentially dangerous complication of Crohn's disease, requiring surgical treatment. Key words: Crohn's disease, fistulas, urinary complications, enterovesical fistulas (EN)




Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 19, No 4 (2006) (EN)

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