Crohn's Disease Complicated with Duodenocolic Fistula: A Case Report

Abstract

A 62-year-old woman with a history of CD for 13 years and hepatitis B virus infection was admitted because of general weakness, body weight loss (4 kg in 5 months), and pitting edema on the legs for 1 month. The patient had undergone previous surgeries for left leg fracture and a thyroid nodular goiter. A follow-up colonoscopy within 5 years before this admission demonstrated inflammation with edematous and ulcerated mucosa at the ascending colon and ileal-cecal valve. Before the current admission, the Montreal classification for CD of this patient was A3 (age, >40), L2 (colonic involvement), B1 (non-stricturing, non-penetrating pattern). She had chronic diarrhea and was receiving regular therapy with mesalazine (1,000 mg twice a day) and azathioprine (50 mg per day) and intermittent therapy with prednisolone (10 mg twice a day) for 2 years. Furthermore, she regularly received entecavir to control hepatitis B. However, the frequency of diarrhea had increased (from twice per day to 7-8 times per day) in recent weeks. Two weeks before this admission, the patient visited another hospital where an upper gastrointestinal barium series showed irregularity at Crohn’s Disease Complicated with Duodenocolic Fistula: A Case Report