Enterovesical fistula complicating Crohn's ileocolitis. 1984

W H Schraut, and G E Block

An enterovesical fistula, an infrequent complication of Crohn's ileocolitis which is considered to constitute a difficult surgical problem, was encountered in 29 patients. These patients had been treated for Crohn's disease by medical means for years and several had previously undergone bowel resections. An exacerbation of the Crohn's disease occurred in all patients coincident with the appearance of dysuria or the obvious clinical presentation (fecaluria) of the fistula. Other manifestations of active Crohn's disease frequently coexisted. Radiographic evaluation was of limited help in establishing the presence of the fistula. Cystoscopy was suggestive of the diagnosis in 18 of 20 patients so examined. Treatment consisted of ileocecal resection with primary anastomosis (25) or exteriorization (4). The bladder defect was sparingly excised and closed with absorbable sutures. One patient developed a bladder leak which closed spontaneously. Recovery was uneventful in the others. An ileovesical fistula constitutes an indication for operation not only to eradicate the urinary sepsis but also to correct the other complications (malnutrition, obstruction, abscess) of Crohn's disease. To assure an uncomplicated course, emphasis must be placed on an individually designed correct approach to the (causative) intestinal problem, while the surgical aspects of the bladder defect can be a matter of routine.

UI MeSH Term Description Entries
D007081 Ileostomy Surgical creation of an external opening into the ILEUM for fecal diversion or drainage. This replacement for the RECTUM is usually created in patients with severe INFLAMMATORY BOWEL DISEASES. Loop (continent) or tube (incontinent) procedures are most often employed. Loop Ileostomy,Tube Ileostomy,Continent Ileostomy,Incontinent Ileostomy,Continent Ileostomies,Ileostomies,Ileostomies, Continent,Ileostomies, Incontinent,Ileostomies, Loop,Ileostomies, Tube,Ileostomy, Continent,Ileostomy, Incontinent,Ileostomy, Loop,Ileostomy, Tube,Incontinent Ileostomies,Loop Ileostomies,Tube Ileostomies
D007412 Intestinal Fistula An abnormal anatomical passage between the INTESTINE, and another segment of the intestine or other organs. External intestinal fistula is connected to the SKIN (enterocutaneous fistula). Internal intestinal fistula can be connected to a number of organs, such as STOMACH (gastrocolic fistula), the BILIARY TRACT (cholecystoduodenal fistula), or the URINARY BLADDER of the URINARY TRACT (colovesical fistula). Risk factors include inflammatory processes, cancer, radiation treatment, and surgical misadventures (MEDICAL ERRORS). Cholecystoduodenal Fistula,Colovesical Fistula,Enterocutaneous Fistula,Fistula, Cholecystoduodenal,Fistula, Colovesical,Fistula, Enterocutaneous,Fistula, Intestinal
D009748 Nutrition Disorders Disorders caused by nutritional imbalance, either overnutrition or undernutrition. Nutritional Disorders,Nutrition Disorder,Nutritional Disorder
D010288 Parenteral Nutrition The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D001747 Urinary Bladder Fistula An abnormal passage in the URINARY BLADDER or between the bladder and any surrounding organ. Vesical Fistula,Fistula, Urinary Bladder,Fistula, Vesical,Fistulas, Urinary Bladder,Fistulas, Vesical,Urinary Bladder Fistulas,Vesical Fistulas
D003424 Crohn Disease A chronic transmural inflammation that may involve any part of the DIGESTIVE TRACT from MOUTH to ANUS, mostly found in the ILEUM, the CECUM, and the COLON. In Crohn disease, the inflammation, extending through the intestinal wall from the MUCOSA to the serosa, is characteristically asymmetric and segmental. Epithelioid GRANULOMAS may be seen in some patients. Colitis, Granulomatous,Enteritis, Granulomatous,Enteritis, Regional,Ileitis, Regional,Ileitis, Terminal,Ileocolitis,Crohn's Disease,Crohn's Enteritis,Inflammatory Bowel Disease 1,Regional Enteritis,Crohns Disease,Granulomatous Colitis,Granulomatous Enteritis,Regional Ileitides,Regional Ileitis,Terminal Ileitis
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000038 Abscess Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. Abscesses

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