title: A complex ileovaginal fistula with associated obstructive uropathy in a patient with Crohn's disease: technical considerations and review of the literature.
abstract: A high index of suspicion of an ileogenital fistula should be aroused by a patient with Crohn's disease, weight loss, malnutrition, and a persistent vaginal discharge. Preoperative gastrointestinal and genitourinary evaluation should be used in an attempt to localize the fistulous origin as well as concomitant fistulae. The principles of surgical therapy include preoperative ureteral catheters, resection of the diseased bowel and fistulous segment of bowel, and interposition of healthy tissue (ie, omentum) between the bowel anastomosis and the vaginal cuff.
authors.affiliation: Department of Surgery, Georgia Baptist Medical Center, Atlanta.
authors.forename: D R
authors.initials: DR
authors.lastname: Baird
authors.forename: G R
authors.initials: GR
authors.lastname: Orangio
authors.forename: G W
authors.initials: GW
authors.lastname: Lucas
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology*; D007077:Ileal Diseases / Q000209:etiology* / Q000601:surgery; D007412:Intestinal Fistula / Q000209:etiology* / Q000601:surgery; D014517:Ureteral Obstruction / Q000209:etiology*; D014624:Vaginal Fistula / Q000209:etiology* / Q000601:surgery