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Crohn's Disease Complicated by Retroperitoneal Abscess and Fistula Treated with Single-Incision Laparoscopic Subtotal
Tomohiro Minagawa1,2, Kenji Watanabe2,3, Yusuke Takashima3,4
1Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Toyama, Japan.
Introduction:
Crohn's disease (CD) can be complicated by complex fistulas and abscesses, and laparoscopic surgery for such cases is difficult. We report a patient with CD who developed a complex fistula and retroperitoneal abscess that were treated using single-incision laparoscopic surgery.
Case Presentation:
A 34-year-old man presented to the hospital after collapsing and losing consciousness while at work. Blood tests showed a white blood cell count of 20000/μL and severe anemia. Abdominal CT showed a right retroperitoneal abscess, which was drained under CT guidance. After gastrointestinal bleeding and an anal fistula were observed, CD was suspected and confirmed by total colonoscopy. The patient was eventually discharged but readmitted 2 months later for abscess recurrence and a colocutaneous fistula. Once the inflammation had improved after 3 weeks of fasting and intravenous antibiotics, the patient underwent single-incision laparoscopic subtotal colectomy, duodenal fistula closure, and seton drainage.
Conclusions:
Single-incision laparoscopic subtotal colectomy can be performed safely to treat CD-related abscesses and complicated fistulas after inflammation has improved.
