クローン病による回腸膀胱痩の1例

Abstract

A 43-year-old woman was admitted on October 6, 1987 with the chief complaint of fecaluria, pneumaturia and miction pain. She had been diagnosed as Crohn's disease in March, 1987. Urinalysis revealed numerous leucocytes, and streptococcus faecium was identified by urine culture. Contrast film of small intestines showed ileovesical fistula arising from terminal ileum. Cystoscopy revealed a papillary tumor-like appearance at the dome of the bladder. An operation was performed on November 9 under the diagnosis of ileovesical fistula complicating Crohn's disease. It was found that ileal region formed a hard adhesion to the bladder wall. Partial resection of the ileum and bladder was performed. Ileovesical fistula was found in the adhesion. Histological diagnosis of the affected ileum was Crohn's disease, showing noncaseating granuloma with the multinucleated giant cells. This case is the first report of female urological complication of the Crohn's disease in the Japanese literature.