A CASE REPORT OF ILEOVESICAL FISTULA IN CROHN'S DISEASE

• Published in: Japanese Journal of National Medical Services Vol. 48; no. 8; pp. 630 - 633
• Main Authors: SHIMADA, Masaaki, SUGA, Shoji, IWASE, Hiroaki, NISHIO, Yuuji, INDOH, Michiko, SUGITA, Youichi, AOTA, Yasuhiro, KYOUKANE, Kazuhiro, NAGAI, Hirofumi, MORISE, Kimitomo
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1994
• Subjects: Crohn's disease; ileovesical fistula; therapy
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.48.630

We experienced a patient with ileovesical fistula due to Crohn's disease. A 25-year-old male was suffered from diarrhea, abdominal pain, fever and fecaluria. He was diagnosed as having Crohn's disease in other hospital in 1988. He was admitted on July 1, 1991 with the complaints as mentioned above. Laboratory finding showed hypoproteinemia and elevated CRP, and Citrobacter freundii was identified by the urinary and fecal examination. Intravenous pyelography, cystography, cystoscopy and CT-scan revealed an elevated lesion in the right posterior wall of the bladder. A barium enema study showed various abnormal findings of ileocecum, with many pseudopolyps with ascending colon and sigmoid colon, and linear ulcer at sigmoid colon. By fluoroscopic examination of the small intestine the bladder was visualized simultaneously. Accordingly an ileovesical fistula due to Crohn's disease was given. First, the patient was treated medically, but the fecaluria lesion was intractable to the treatment. Ileocecal resection and partial cystectomy were performed on September 24. Macroscopic examination of the terminal ileum showed an abscess associated with ileovesical fistula. After operation, he had an uneventful recovery and was discharged on January 13, 1992. At present, recurrence of fistula was not observed.