Bladder fistulae in Crohn's disease.

Area of Science:

• Gastroenterology
• Urology
• Surgical Oncology

Background:

• Crohn's disease is a chronic inflammatory condition that can affect any part of the gastrointestinal tract.
• Enterovesical fistulas, abnormal connections between the intestine and bladder, are a known complication of Crohn's disease.
• These fistulae can significantly impact patient quality of life and present diagnostic challenges.

Observation:

• This study discusses ten patients with enterovesical fistulization in Crohn's disease.
• Fistulae development can occur at various stages of the disease, sometimes being the initial presenting symptom.
• Diagnostic methods like cystoscopy and radiologic examination frequently fail to visualize these fistulae.

Findings:

• Conservative treatment with medication can alleviate symptoms but does not provide a cure for enterovesical fistulas.
• Surgical treatment, involving intestinal resection (with or without bladder resection), demonstrates positive outcomes.
• Surgical intervention is particularly effective in resolving associated urinary tract infections.

Implications:

• Early recognition and appropriate management of enterovesical fistulas are crucial in Crohn's disease patients.
• Surgical options should be considered for definitive treatment, especially for managing refractory symptoms and infections.
• Further research into less invasive diagnostic and therapeutic approaches may be beneficial.