Coloduodenal and enterocutaneous fistula in twins with Crohn´s disease

We present the case of a pair of 45-year-old monozygotic twins (A and B) diagnosed with Crohn's disease (CD) at age 20 (A) and 22 (B) with similar presenting symptoms: diarrhea, fever and weight loss. Both of them had duodenal and ileocolonic disease (A2, L3+L4 according to Montreal classificat...

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Bibliographic Details
Published in:	Revista española de enfermedades digestivas Vol. 109; no. 4; p. 291
Main Authors:	Ballester, Maíia Pilar, Martí, David, Boscá Watts, Marta Maia, Martín Arévalo, José, Mínguez, Miguel
Format:	Journal Article
Language:	English
Published:	Spain 01-04-2017
Subjects:	Anastomosis, Surgical Colonic Diseases - diagnostic imaging Crohn Disease - complications Crohn Disease - diagnostic imaging Digestive System Fistula - complications Digestive System Fistula - diagnostic imaging Duodenal Diseases - diagnostic imaging Female Humans Intestinal Fistula - diagnostic imaging Middle Aged Twins, Monozygotic
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Summary:	We present the case of a pair of 45-year-old monozygotic twins (A and B) diagnosed with Crohn's disease (CD) at age 20 (A) and 22 (B) with similar presenting symptoms: diarrhea, fever and weight loss. Both of them had duodenal and ileocolonic disease (A2, L3+L4 according to Montreal classification); twin B also presented jejunal involvement and perianal disease (B1p). They received treatment with antibiotics, corticosteroids, 5-ASA, azathioprine and anti-TNF with a poor control of activity. They both developed a coloduodenal fistula that required surgery. Twin A developed the fistula 12 years after the first presentation; fistula closure with duodenorraphy and ileocolonic resection with gastrojejunostomy was performed. Twin B developed the fistula 22 years after the first presentation, and right colectomy, partial duodenectomy and duodenorraphy was carried out. Both developed an enterocutaneous fistula during the postoperative period. With intensive medical treatment, both twins remain asymptomatic.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1130-0108