Meng-Wu Chung1, Chien-Ming Chen2, Jun-Te Hsu3, Ren-Chin Wu4, Cheng-Tang Chiu5,6, Chia-Jung Kuo5,6, Ming-Yao Su6,7, Puo-Hsien Le8,9,10. 1. Department of Medical Education, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan. 2. Department of Medical Imaging and Interventions, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan. 3. Department of General Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan. 4. Department of Pathology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan. 5. Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, Chang Gung University College of Medicine, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan. 6. Taiwan Association of the Study of Small Intestinal Disease, Taoyuan, Taiwan. 7. Department of Gastroenterology and Hepatology, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan. 8. Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, Chang Gung University College of Medicine, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, 33305, Taiwan. puohsien@gmail.com. 9. Taiwan Association of the Study of Small Intestinal Disease, Taoyuan, Taiwan. puohsien@gmail.com. 10. Liver Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan. puohsien@gmail.com.
Abstract
BACKGROUND: Intestinal perforations and fistulas are common complications of Crohn's disease. However, chronic perforation with peritoneal space to rectal and vaginal fistulas have not been previously reported. CASE PRESENTATION: A 38-year-old female suffered from progressive lower abdominal pain, diarrhea and weight loss. Terminal ileal chronic perforation with intra-abdominal abscess, peritoneal space to rectal and vaginal fistulas were noted. The patient received surgical resection of the cecum and terminal ileum, and then vedolizumab treatment. Three months later, she had complete fistula closure, and her body mass index had increased from 13 to 22. CONCLUSION: Vedolizumab combined with stool diversion is effective at treating Crohn's disease with chronic perforation and complex peritoneal space to rectal and vaginal fistulas.
BACKGROUND: Intestinal perforations and fistulas are common complications of Crohn's disease. However, chronic perforation with peritoneal space to rectal and vaginal fistulas have not been previously reported. CASE PRESENTATION: A 38-year-old female suffered from progressive lower abdominal pain, diarrhea and weight loss. Terminal ileal chronic perforation with intra-abdominal abscess, peritoneal space to rectal and vaginal fistulas were noted. The patient received surgical resection of the cecum and terminal ileum, and then vedolizumab treatment. Three months later, she had complete fistula closure, and her body mass index had increased from 13 to 22. CONCLUSION:Vedolizumab combined with stool diversion is effective at treating Crohn's disease with chronic perforation and complex peritoneal space to rectal and vaginal fistulas.