Ureteric obstruction complicating Crohn's disease in the terminal ileum

Ureteric obstruction complicating Crohn's disease of the terminal ileum is reported in three patients. This complication is treacherous, since symptoms of urinary tract disease are mostly absent, as is laboratory evidence of urinary tract infection. It is concluded that inflammatory ureteral engagement should always be suspected in patients with Crohn's disease, particularly when located in the terminal ileum. A preoperative intravenous pyelography should be included as a routine procedure in these patients. The detection of ureteral obstruction is a strong indication for early operative treatment of the disease. Ureterolysis combined with intestinal resection is recommended. The ureteral involvement, which is most likely a late phenomenon of the disease, could provably be avoided if surgical treatment is instituted at an earlier stage of the disease.