Display options
Cite
Vagianos C, Malgarinos G, Spyropoulos C, et al. Entero-vesical fistulas in CROHN'S disease: A case series report and review of the literature. Int J Surg Case Rep. 2017;41:477-480doi: 10.1016/j.ijscr.2017.11.035.
Vagianos, C., Malgarinos, G., Spyropoulos, C., & Triantafillidis, J. K. (2017). Entero-vesical fistulas in CROHN'S disease: A case series report and review of the literature. International journal of surgery case reports, 41477-480. https://doi.org/10.1016/j.ijscr.2017.11.035
Vagianos, Costantine, et al. "Entero-vesical fistulas in CROHN'S disease: A case series report and review of the literature." International journal of surgery case reports vol. 41 (2017): 477-480. doi: https://doi.org/10.1016/j.ijscr.2017.11.035
Vagianos C, Malgarinos G, Spyropoulos C, Triantafillidis JK. Entero-vesical fistulas in CROHN'S disease: A case series report and review of the literature. Int J Surg Case Rep. 2017 Nov 24;41:477-480. doi: 10.1016/j.ijscr.2017.11.035. eCollection 2017. PMID: 29546021; PMCID: PMC5705824.
Copy Download .nbib Format: NLM
Share it on

Int J Surg Case Rep. 2017 Nov 24;41:477-480. doi: 10.1016/j.ijscr.2017.11.035. eCollection 2017.

Entero-vesical fistulas in CROHN'S disease: A case series report and review of the literature.

International journal of surgery case reports

Costantine Vagianos, George Malgarinos, Charalampos Spyropoulos, John K Triantafillidis

Affiliations

  1. Second Propaedeutic Department of Surgery, Laikon Hospital, University of Athens, Athens, Greece.
  2. Inflammatory Bowel Disease Unit, IASO General Hospital, Holargos, Greece.
  3. Third Department of Surgery, IASO General Hospital, Holargos, Greece. Electronic address: [email protected].

PMID: 29546021 PMCID: PMC5705824 DOI: 10.1016/j.ijscr.2017.11.035

Abstract

BACKGROUND: Entero-vesical fistula (EVF) is an abnormal link between the enteric lumen and the urinary bladder. Crohn's disease (CD) represents, nowadays, the most common cause in the formation of this fistula.

MATERIALS AND METHODS: The aim of this study was to describe the diagnostic and treating modalities applied in nine patients with CD and EVFs, the clinical/epidemiological features of this clinical entity and to perform a systemic review of the literature, concerning the diagnosis and treatment of this complication.

RESULTS: The medical records of eight men and one woman (mean age 42 ± 12 years) with EVFs were analyzed. The terminal ileum and the ileocecal region were affected in three and six cases, respectively. The most common symptoms were pneumaturia, fecaluria, fever, urinary urgency and abdominal pain. The diagnosis was suspected by abdominal CT scan and by indirect findings of bladder infection in cystoscopy. MRI with concurrent cystography set the diagnosis in three patients. Colonoscopy was not helpful. Conservative treatment, including administration of antibiotics and immunosuppressive agents in all patients and anti-TNF-a agent (infliximab) in six patients, was ineffective. Surgical treatment was applied in seven cases (77.8%), including fistula repair in all patients, drainage of coexistent intraabdominal abscess in two, small bowel resection in four and ileocecectomy in two cases.

CONCLUSION: EFVs are uncommon but potentially dangerous complications of CD. Abdominal CT scan and cystoscopy are the most commonly used diagnostic modalities. Surgical treatment seems to be unavoidable in most cases, although medical treatment could also benefit a small cohort of patients.

Keywords: Bladder; Crohn’s disease; Entero-vesical fistula; Surgical treatment

References

  1. J Crohns Colitis. 2010 Feb;4(1):28-62 - PubMed
  2. Hepatogastroenterology. 2006 May-Jun;53(69):357-60 - PubMed
  3. Hepatogastroenterology. 2001 Jul-Aug;48(40):1072-7 - PubMed
  4. Inflamm Bowel Dis. 2002 Mar;8(2):106-11 - PubMed
  5. Nihon Ika Daigaku Zasshi. 1992 Dec;59(6):467-70 - PubMed
  6. Can J Urol. 2014 Apr;21(2):7179-84 - PubMed
  7. Can J Gastroenterol. 2002 Apr;16(4):225-9 - PubMed
  8. J Crohns Colitis. 2016 Jun;10 (6):657-62 - PubMed
  9. Gastroenterology. 2002 Apr;122(4):875-80 - PubMed
  10. Int J Surg. 2016 Dec;36(Pt A):319-323 - PubMed
  11. Case Rep Gastroenterol. 2012 May;6(2):279-84 - PubMed
  12. BMJ Case Rep. 2013 Nov 18;2013:null - PubMed
  13. Surg Clin North Am. 2001 Feb;81(1):197-215, x - PubMed
  14. Digestion. 2000;61(2):121-8 - PubMed
  15. N Engl J Med. 1999 May 6;340(18):1398-405 - PubMed
  16. Colorectal Dis. 2002 Nov;4(6):459-62 - PubMed
  17. Am Surg. 2002 Aug;68(8):714-9 - PubMed
  18. Clin Nutr. 2002 Feb;21(1):51-7 - PubMed
  19. Gastroenterology. 2016 Feb;150(2):315-7 - PubMed
  20. Surg Endosc. 2005 Feb;19(2):222-5 - PubMed
  21. Ann Urol (Paris). 2003 Aug;37(4):180-3 - PubMed
  22. J Clin Gastroenterol. 2016 Oct;50(9):714-21 - PubMed
  23. Am J Gastroenterol. 2002 Sep;97(9):2300-5 - PubMed
  24. J Clin Gastroenterol. 2014 Sep;48(8):708-11 - PubMed

Publication Types