Enterourachal Fistula as an Initial Presentation in Crohn Disease

• Published in: Pediatric gastroenterology, hepatology & nutrition Vol. 22; no. 1; pp. 90 - 97
• Main Authors: Sankararaman, Senthilkumar, Sabe, Ramy, Sferra, Thomas J, Khalili, Ali Salar
• Format: Journal Article
• Language: Korean
• Published: 2019
• Subjects: Crohn disease; Inflammatory bowel diseases; Intestinal fistula; Urachus
• ISSN: 2234-8646; 2234-8840

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.