We report the case of a patient with Crohn’s disease who initially presented with a ceco-urachal fistula. The patient was a 31-year-old female who underwent an appendectomy 6 years before presenting to our institution. She had a one-year history of diarrhea, and had recently developed polyuria and a sensation of residual urine. She was admitted with fever and lower abdominal pain. Endoscopy and computed tomography revealed a ceco-urachal fistula, which was consistent with Crohn’s disease. An urachal resection was performed, which included partial cystectomy and ileocecal resection. A ceco-urachal fistula is a rare initial symptom of Crohn’s disease. During the surgical management of such cases, it is necessary to resect the urachus, the affected portion of the bladder, the fistula, and the affected part of the digestive tract in order to avoid recurrence.
Crohn’s disease Ceco-urachal fistula Resection
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Compliance with ethical standards
Conflict of Interest:
The authors declare that they have no conflicts of interest.
All procedures were performed in accordance with the ethical standards of the committees responsible for human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
The patient gave informed consent for the publication of the case.
Thia KT, Sandborn WJ, Harmsen WS, et al. Risk factors associated with progression to intestinal complications of Crohn’s disease in a population-based cohort. Gastroenterology. 2010;139:1147–55.CrossRefPubMedPubMedCentralGoogle Scholar
Greenstein AJ, Sachar DB, TzaTzakis A, et al. Course of enterovesical fistulas in Crohn’s disease. Am J Surg. 1984;147:788–92.CrossRefPubMedGoogle Scholar
Solem CA, Loftus EV Jr, Tremaine WJ, et al. Fistulas to the urinary system in Crohn’s disease: clinical features and outcomes. Am J Gastroenterol. 2002;97:2300–5.CrossRefPubMedGoogle Scholar