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A Journal on Surgery

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Chirurgia 2001 April;14(2):105-8

language: Italian

Chron's disease with fistula through bladder and terminal ileal loop

Ragazzi R., Capizzi G., Pace G., Cremona S., Turtulici B., Vaccaro R., Di Pietro S., Buttafuoco A., Ragazzi S., Gulino V.


The authors, after discussing Crohn's disease and its genitourinary complications (16.9%) like enterovesical fistulas (3.7%), right ureterohydronephrosis (2.8%) and obstructive uropathy (3.7%), present a case of Crohn's disease in which the patient complained of cystitis, pneumaturia and faeces in the urine due to the enterovesical fistula. The patient also presented an endoabdominal pelvic mass consisting of terminal ileal loops adherent to the bladder. The ileal-vesical fistula was shown by excretory urography and especially by barium studies of the ileum. The surgical technique included the resection of the vesical wool with the fistulous track and subsequent cystorrhaphy, followed by right hemicolectomy and ileum-transverse anastomosis. Histologic examination confirmed the diagnosis made before surgery. The patient responded to the mentioned treatment without recurrence. The authors present the case report both because of the unusual presenting symptoms and the rare location of the disease in order to make a personal contribution to the understanding of this particular syndrome.

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