Two Cases Report of the Crohn's Disease that formed Colonic-Duodenal Fistula

Eiji Noda, Kiyoshi Maeda, Toru Inoue, Tamahiro Nishihara, Masakazu Yashiro, Nobuya Yamada, Yoshito Yamashita, Tetsuji Sawada, Masaichi Ohira and Kosei Hirakawa

Department of Surgical Oncology, Osaka City University Graduate School of Medicine

We reported two cases of Crohn's disease associated with duodenal colonic fistulas treated surgical. Case 1; A 35-year-old man admitted for right-side hypochondralgia and anal pain was found in gastrointestinal endoscopy to have stenosis at the second portion of the duodenum. Upper gastrointestinal X-ray showed stenosis at the terminal ileum and a fistula between the caecum and terminal ileum. Fistulography confirmed a fistula between the duodenal bulb and terminal colon. Abdominal CT showed that an abscess had formed in the hepatic circumference. Case 2; A 23-year-old man seen for pyrexia and anal pain and having a 9-year history of Crohn's disease underwent colonic stenosis. Five years after the operation, colonoscopy and fistelography showed a fistula between the transverse colon and duodenum. Conservative preoperative treatment failed to close the fistulas necessitating transverse colon resection in case 2. Both men required fistulectomy, simple closure of the duodenal component of the fistulas and omental patching.

Key words
colonic-duodenal fistula, Crohn's disease, internal fistula

Reprint requests
Kiyoshi Maeda Department of Surgical Oncology, Osaka City University Graduate School of Medicine
1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585 JAPAN

Accepted
November 30, 2005

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