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Enterovenous fistulization: a rare complication of Crohn's disease

Jeong Woo Lim1, Kyung-Jo Kim, Byong Duk Ye

  • 1Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, South Korea.

World Journal of Gastroenterology
|January 5, 2012
PubMed

Insights

Hepatic portal venous gas (HPVG) in Crohn's disease can be serious but is rarely caused by enterovenous fistula. Surgical management of HPVG secondary to fistula in Crohn's disease can lead to favorable outcomes.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Diagnostic Imaging

Background:

  • Hepatic portal venous gas (HPVG) is a rare finding often linked to severe conditions.
  • While typically associated with poor prognosis, HPVG in inflammatory bowel disease (IBD) can have benign courses.
  • Enterovenous fistula is an uncommon cause of HPVG in IBD patients.

Observation:

  • A case of a 32-year-old man with Crohn's ileocolitis presenting with HPVG, hypotension, fever, and superior mesenteric vein thrombosis is described.
  • The patient's condition was potentially caused by an enterovenous fistula.
  • The patient successfully managed through surgical intervention.

Findings:

  • HPVG in Crohn's disease is infrequently caused by enterovenous fistula.
  • Superior mesenteric vein thrombosis can occur concurrently with HPVG in this context.
  • Surgical intervention can be a viable treatment for HPVG secondary to enterovenous fistula in Crohn's disease.

Implications:

  • This case highlights the importance of considering enterovenous fistula as a cause of HPVG in IBD patients.
  • Early diagnosis and surgical management may improve outcomes for patients with HPVG and associated complications like thrombosis.
  • Further research into the specific mechanisms and optimal management strategies for HPVG in Crohn's disease is warranted.
Keywords:
Crohn’s diseaseEnterovenous fistulaPortal venous gas

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