Crohn’s Disease and Urinary Manifestations: A Crohn’s Intestinal Disease Mimicking a Bladder Mass

Bronislava Papadatou,Giuliano Torre,Lidia Monti,Fabio Panetta,Antonella Diamanti

doi:10.4236/health.2014.612182

Bronislava Papadatou, Giuliano Torre + Show 3 more

Open Access

https://doi.org/10.4236/health.2014.612182

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Journal: Health	Publication Date: Jan 1, 2014
Citations: 7	License type: CC BY 4.0

Affiliation: Bambino Gesù Children's Hospital

Abstract

We report a rare mode of presentation of Crohn’s Disease (CD) in a 17-year-old boy, who was admitted at our hospital due to abdominal pain, dysuria, polyuria and fever. The ultrasound showed an increased wall thickness of the small bowel and cecum and a vegetating lesion adjoined into the bladder. The histology was not suggestive of CD and it excluded the bladder neoplasm. Based on the biochemical assessment and the imaging, we started the treatment specific for CD (nutritional therapy by Modulen, short courses of steroids, azathioprine and mesalazine during the follow up), These treatments improved the gastrointestinal symptoms and the nutritional status of our patient but also induced the disappearance of the mass adjoined into the bladder. In spite of the severe onset, in this patient, the clinical course of CD was mild and responder to conventional therapy.

Highlights

Crohn’s Disease (CD) is a chronic, relapsing and remitting inflammatory disease of the gastrointestinal tract
We describe a case where a 17-year-old boy who presented as an emergency with abdominal pain, dysuria, polyuria and fever due to the presence of an urinary bladder mass, revealed a previously undiagnosed CD
The histologic evaluation of the specimens demonstrated the presence of lymphoidaggregatesin both the colon and the cecum combined with cryptic abscesses and neutrophil infiltrates more suggestive of an inflammatory bowel disease than the first one

Summary

Introduction

Crohn’s Disease (CD) is a chronic, relapsing and remitting inflammatory disease of the gastrointestinal tract. It has a prevalence of 140 cases per 100,000 in the West [1], and is characterized by transmural, patchy and granulomatous inflammation [1] [2]. Disorders of the urinary tract are well known complications of Crohn’s disease (CD), especially if the terminal ileum is involved [3]. We describe a case where a 17-year-old boy who presented as an emergency with abdominal pain, dysuria, polyuria and fever due to the presence of an urinary bladder mass, revealed a previously undiagnosed CD

Case Report

Discussion