title: Crohn's disease presenting as a ceco-urachal fistula.
abstract: We report the case of a patient with Crohn's disease who initially presented with a ceco-urachal fistula. The patient was a 31-year-old female who underwent an appendectomy 6 years before presenting to our institution. She had a one-year history of diarrhea, and had recently developed polyuria and a sensation of residual urine. She was admitted with fever and lower abdominal pain. Endoscopy and computed tomography revealed a ceco-urachal fistula, which was consistent with Crohn's disease. An urachal resection was performed, which included partial cystectomy and ileocecal resection. A ceco-urachal fistula is a rare initial symptom of Crohn's disease. During the surgical management of such cases, it is necessary to resect the urachus, the affected portion of the bladder, the fistula, and the affected part of the digestive tract in order to avoid recurrence.
authors.affiliation: Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. yesterdayoncemore0228@gmail.com.
authors.forename: Hidenori
authors.identifier: http://orcid.org/0000-0003-4698-5207
authors.initials: H
authors.lastname: Tsukui
authors.affiliation: Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Koinuma
authors.affiliation: Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Morimoto
authors.affiliation: Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Hisanaga
authors.initials: H
authors.lastname: Horie
authors.affiliation: Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Alan Kawarai
authors.initials: AK
authors.lastname: Lefor
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kagaya
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yano
authors.affiliation: Diagnostic Pathology, Jichi Medical University, Tochigi, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsubara
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Sata
mesh_terms: D000328:Adult; D002429:Cecal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003113:Colonoscopy; D003424:Crohn Disease / Q000150:complications*; D058582:Double-Balloon Enteroscopy; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014497:Urachus / Q000601:surgery
keywords: Ceco-urachal fistula; Crohn’s disease; Resection