Abstract
A case of Crohn's disease with an ileovesical fistula is reported. The patient was a 44-year-old man. He had undergone a fistula-in-ani operation, and Crohn's disease was diagnosed in 1980. He had complained of “fecaluria”, and had medical therapy since 1992. Five years later, he was admitted to the hospital because of high fever and back pain. Urinalysis revealed numerous leucocytes and Enterococcus was identified by urine culture. Barium enema showed ileo-colonic fistula and stenosis. Hydronephrosis and right ureter stenosis were revealed by nephrography. CT showed a bubble in the bladder.
He underwent an operation, including right-hemicolectomy and ileo-vesical fistula resection. Postoperative course was satisfactory. He is followed in our outpatient clinic without recurrence of fistula. The authors consider that entero-vesical fistula due to Crohn's disease requires surgical treatment, because it is difficult to be cured by only medical therapy in 94 cases seen in the Japanese literature. The importance is the time when surgical treatment should be performed for the patient's QOL.
