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Enterovesical fistula complicating pregnancy. A case report
E V Forsnes1, M K Eggleston, J O Heaton
1Department of Obstetrics and Gynecology, Naval Medical Center, Portsmouth, Virginia, USA.
The Journal of Reproductive Medicine
|April 15, 1999
Summary
Enterovesical fistula, a rare condition causing recurrent urinary tract infections, can complicate pregnancy. This case highlights it as an early symptom of Crohn's disease in a pregnant patient.
Area of Science:
- Gastroenterology
- Urology
- Obstetrics
Background:
- Enterovesical fistula is a rare cause of recurrent urinary tract infections (UTIs), with diverticular disease and cancer being common etiologies.
- Crohn's disease is a frequent cause of enterovesical fistula in women of childbearing age.
- Enterovesical fistula complicating pregnancy is an exceedingly rare occurrence, with limited prior reports.
Observation:
- A pregnant patient presented with recurrent UTIs, leading to suspicion of an enterovesical fistula.
- Diagnostic confirmation included cystoscopy and charcoaluria test.
- The pregnancy was complicated by hemorrhagic cystitis despite antibiotic prophylaxis.
Findings:
- Postpartum evaluation, including upper gastrointestinal series, confirmed an enterovesical fistula and suggested Crohn's disease.
- Surgical repair three months after delivery revealed Crohn's disease as the underlying cause.
- The enterovesical fistula presented as the initial symptom of Crohn's disease.
Implications:
- Enterovesical fistula should be considered in pregnant patients experiencing recurrent UTIs.
- This case underscores the importance of considering inflammatory bowel disease in the differential diagnosis of enterovesical fistula during pregnancy.
- Early diagnosis and management are crucial for favorable maternal and fetal outcomes.