Jurnalul de Chirurgie
 Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | miercuri, 19 iunie 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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ILEORECTAL FISTULA FROM CROHN ILEOCOLITIS WITH MALIGNANT CHANGE – CASE REPORT
Elena Gologan (1), A. Pantazescu (2), Iuliana Eva (3), Doiniţa Rădulescu (4), Doina Butcovan (4)
(1) Gastroenterlology and Hepatology Institute
(2) Surgical Clinic, „St. John” Emergency Clinic Hospital
(3) Department of Medical Imagery, Military Hospital
(4) Department of Pathology
„Gr.T. Popa” University of Medicine and Pharmacy Iaşi
Jurnalul de chirurgie 2009; 5 (1): 82-85
Full text:
Format PDF (Română/Romanian)

Abstract:

Crohn’s disease is an inflammatory bowel disease with a total wall involvement which leads to the possibility of extramural complications as fistula. We present a 28 years old patient admitted for pain in the lower right quadrant of the abdomen, fever, chills, weight loss and anorexia. Clinical examination revealed a tumor in the lower right quadrant and moderate fever. Biochemical and hematological investigations identified a nonspecific inflammatory syndrome. Carcinoembrionar antigen was negative. All the imagistic (barium enema and computer tomography) and endoscopic (left colonoscopy – there was no possibility to reach the right colon) investigations could not established the diagnostic, but these investigations identified the intestinal tumor involving cecum and terminal ileon, with mostly benign characters and loco-regional enlarged limph nodes. The surgical exploration showed an inflammatory tumor of the terminal ileon and cecum with ileo-rectal fistula; extended enterectomy, right colectomy, excision of the ileo-rectal fistula and ileo-colic anastomosis were performed The pathological exam revealed Crohn`s disease but with three nests of malignant cells. The postoperative course was uneventful and the patient was discharged in 7 days.

KEY WORDS: CROHN’S DISEASE, ILEO-COLIC FISTULA, CANCER, RIGHT COLECTOMY

Correspondence to: Elena Gologan, MD, Gastroenterlology and Hepatology Institute Iaşi, Independenţei Street, No. 1, 700111, Iaşi, Romania.



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Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.