Urologic complications in Crohn's disease: suspicion criteria.
OBJECTIVE
Genitourinary complications occur in 4 to 35% of Crohn's disease patients. The aim of this study was to assess the threshold to suspect urologic involvement in Crohn's disease in order to plan the correct surgical management.


METHODS
Medical records of 258 consecutive patients who have undergone bowel resection for Crohn's disease were reviewed. We evaluated recurrent urinary tract infections, fever, dysuria, pneumaturia, fecaluria, abdominal mass at palpation or lower back pain at percussion, abdominal ultrasound and computerized tomography scan reports. Univariate analysis and multivariate analysis were performed with Fisher exact and log-linear tests respectively.


RESULTS
Urologic complications were found in 11 patients (4.3%). Fistulizing disease, female gender and inflammatory mass were significantly increased in Crohn's disease patients with urinary tract involvement (p < 0.01). Ultrasound and computerized tomography scan demonstrated good specificity, sensibility, positive and negative predicting values for urologic complications.


CONCLUSIONS
In the presence of abdominal mass in a Crohn's disease patient, the following step should be abdominal ultrasound or computerized tomography scan to rule out involvement of the ureter that should be treated previously to improve the intraoperative picture and patient general status.
Ruffolo
Cesare
C
Clinica Chirurgica I, Department of Surgical and Gastroenterological Sciences, University of Padova, Italy.
Angriman
Imerio
I
Scarpa
Marco
M
Polese
Lino
L
Pagano
Duilio
D
Barollo
Michela
M
Bertin
Matteo
M
D'Amico
Davide Francesco
DF
D018784:Abdominal Abscess / Q000150:complications* / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003424:Crohn Disease / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D052776:Female Urogenital Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014513:Ureter / Q000000981:diagnostic imaging