A Case of Ileovesical Fistula due to Crohn's Disease

Miki Shibusawa, Wataru Matsui, Takashi Kato, Ippei Kamiji, Hiroto Yoshizawa, Kentaro Nakao, Sadaaki Kato, Akira Tsunoda, Tadashi Koike

Department of Surgery, Showa University, School of Medicine

This paper reports a case of Crohn's disease of the ileocecum with ileovesical fistula manifested by urinary tract infection. This patient was a 63-year-old female undergoing hemodialysis because of chronic renal failure, who visited our hospital because of pyuria. Barium enema X-ray examination revealed ileocolic type Crohn's disease with an ileovesical fistula. Ileocecal resection and partial cystectomy were performed. Macroscopic examination of the terminal ileum showed a wall thickening and a cobble-stone appearance around the ileovesical fistula. Proximately a longitudinal ulcer 25 cm in length was also observed. Microscopic findings of a cross section of the terminal ileum showed transmural inflammation and fissuring ulcers. Thirty-three cases of ileovesical fistula due to Crohn's disease have been reported in Japan, there were only two women including this case. This seems to be the first report in which the ileovesical fistula was demonstrated in a patient with Crohn's disease complicated by chronic renal failure.

Key words
ileovesical fistula, Crohn's disease, chronic renal failure

Reprint requests
Miki Shibusawa Department of Surgery, Showa University, School of Medicine
1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142 JAPAN

Accepted
October 11, 1990

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