Minimally invasive management of Crohn's disease complicated by ureteral stenosis.
Ureteral involvement due to Crohn's disease occurs in 3% to 6% of cases. Herein, we present a case of a 22-year-old woman with ileocolic Crohn's disease with right hydronephrosis due to compression of the ureter that was resolved with a 3-stage, minimally invasive procedure (preoperative percutaneous nephrostomy, ureteral stent placement, and sequential laparoscopically assisted ileocolectomy). Percutaneous right nephrostomy drainage permitted us to prevent renal damage before surgery, and successive ureteral double-J catheter placement minimized the risk of ureteral damage during the laparoscopic procedure. The safety and feasibility of sequential minimally invasive management of ileocolonic Crohn's disease involving the right ureter was assessed, and a good cosmetic result was achieved.
Ruffolo
Cesare
C
Department of Surgical and Gastroenterological Sciences, Clinica Chirurgica I, University of Padova, Padova, Italy. cruffolo@hotmail.com
Angriman
Imerio
I
Scarpa
Marco
M
Polese
Lino
L
Barollo
Michela
M
Bertin
Matteo
M
Pagano
Duilio
D
D'Amico
Davide Francesco
DF
D000328:Adult; D003082:Colectomy; D003251:Constriction, Pathologic; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009403:Nephrostomy, Percutaneous; D019919:Prosthesis Implantation; D015607:Stents; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*