Vaginal fistulas in Crohn's disease
作者:
Francoise Heyen,
M. Winslet,
H. Andrews,
J. Alexander‐Williams,
M. Keighley,
期刊:
Diseases of the Colon & Rectum
(OVID Available online 1989)
卷期:
Volume 32,
issue 5
页码: 379-383
ISSN:0012-3706
年代: 1989
出版商: OVID
关键词: Vaginal fistula;Crohn's disease;Proctectomy;Carcinoma in fistula;Perineal sinus;Stoma
数据来源: OVID
摘要:
&NA;Twenty‐eight patients with vaginal fistulas complicating Crohn's disease, seen between 1970 and 1987, are described. Twelve required early operation; five of them had rectal excision. Conservative management was used in 16 patients but in none of these did the fistula close spontaneously. Subsequent proctocolectomy was required in seven patients though two patients with high vaginal fistulas were managed by total colectomy, end ileostomy, and oversewing of the rectal stump. Only two high fistulas resulting from ileal Crohn's disease resolved with resection and anastomosis of the diseased segment alone. Local repair was unsuccessful despite repeated operations in two of five patients. Two patients died of malignancy arising within a chronic vaginal fistula. Although some vaginal fistulas complicating Crohn's disease cause little disability and can be managed symptomatically, they do not heal by conservative therapy or by a proximal defunctioning stoma alone. In time, severe bowel symptoms develop in the majority of patients and necessitate proctectomy.
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