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Published on: June 16, 2022
Crohn's disease presenting as a ceco-urachal fistula
Hidenori Tsukui1, Koji Koinuma2, Mitsuaki Morimoto2
1Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. yesterdayoncemore0228@gmail.com.
Insights
A rare initial presentation of Crohn's disease as a ceco-urachal fistula was observed in a 31-year-old female. Surgical management requires resection of the urachus, bladder, fistula, and affected bowel to prevent recurrence.
Area of Science:
- Gastroenterology
- Urology
Background:
- Crohn's disease is a chronic inflammatory bowel disease.
- Ceco-urachal fistulas are rare congenital anomalies or acquired conditions.
Observation:
- A 31-year-old female with a history of appendectomy presented with diarrhea, polyuria, and abdominal pain.
- Imaging revealed a ceco-urachal fistula, leading to the diagnosis of Crohn's disease.
Findings:
- The ceco-urachal fistula was confirmed as an initial manifestation of Crohn's disease.
- Surgical intervention involved urachal resection, partial cystectomy, and ileocecal resection.
Implications:
- This case highlights a rare initial presentation of Crohn's disease.
- Complete surgical resection is crucial for managing ceco-urachal fistulas in Crohn's disease to prevent recurrence.
Abstract:
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.
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