Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Enterourachal Fistula as an Initial Presentation in Crohn Disease

  • Sankararaman, Senthilkumar (Division of Pediatric Gastroenterology, Department of Pediatrics, UH Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine) ;
  • Sabe, Ramy (Division of Pediatric Gastroenterology, Department of Pediatrics, UH Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine) ;
  • Sferra, Thomas J. (Division of Pediatric Gastroenterology, Department of Pediatrics, UH Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine) ;
  • Khalili, Ali Salar (Division of Pediatric Gastroenterology, Department of Pediatrics, UH Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine)
  • Received : 2017.12.07
  • Accepted : 2018.04.07
  • Published : 2019.01.15
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Abstract

Crohn disease has a wide spectrum of clinical presentations and rarely can present with complications such as a bowel stricture or fistula. In this case report, we describe a 17-year-old male who presented with a history of recurrent anterior abdominal wall abscesses and dysuria. He was diagnosed with Crohn disease and also found to have a fistulous communication between the terminal ileum and a patent urachus. An ileocecectomy with primary anastomosis and complete resection of the abscess cavity was performed. He is on azathioprine for maintenance therapy and currently in remission. Clinicians should have a high index of suspicion for this complication in Crohn disease patients presenting with symptoms suggestive of urachal anomalies such as suprapubic abdominal pain, dysuria, umbilical discharge, and periumbilical mass.

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References

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