Abstract
Fistula formation is one of the complications of Crohn's disease, although spontaneous umbilical fistula in Crohn's disease is extremely rare. A 37-year-old man who presented with lower abdominal pain and frequent urination was referred to our hospital for examination of abnormality of the bladder. We diagnosed an urachal abscess on abdominal computed tomography (CT), drainage was performed through the umbilical. Intestinal fluid was discharged from the drain, and a fistulography revealed the urachus penetrating to the ileum. Thirty-seven days after drainage, the fistula did not close, so we performed a laparotomy. The terminal ileum and the sigmoid colon were found to be adherent to the urachus, resection of the urachus and the involved portion of the ileum, the sigmoid colon, and the bladder was performed. The resected specimen of the ileum showed a longitudinal ulcer and stricture. Histopathologically, the lymphoid follicles and ulcer were found in the ileum. He was discharged without complication on the 11th postoperative day. Eleven months later, he underwent a colonoscopy due to frequent diarrhea and was diagnosed pathologically with Crohn's disease. We performed surgical treatment after drainage for spontaneous umbilical fistula in Crohn's disease.
