1. Vedolizumab in Crohn’s disease with rectal fistulas and presacral abscess: A case report
- Author
-
Wen-Sy Tsai, Heng Yeh, Ren-Chin Wu, Ming-Yao Su, Chia-Jung Kuo, Cheng-Tang Chiu, Puo-Hsien Le, and Chien-Ming Chen
- Subjects
medicine.medical_specialty ,Abdominal pain ,Cirrhosis ,Percutaneous ,Fistula ,Vedolizumab ,03 medical and health sciences ,0302 clinical medicine ,Case report ,Medicine ,Abscess ,Crohn's disease ,business.industry ,Rectoprostatic fistula ,Gastroenterology ,General Medicine ,medicine.disease ,Surgery ,030220 oncology & carcinogenesis ,Pre-sacral abscess ,030211 gastroenterology & hepatology ,Bloody diarrhea ,Rectal pre-sacral fistula ,medicine.symptom ,business ,medicine.drug - Abstract
Background Fistula and intraabdominal fistula are common complications of Crohn's disease (CD), but complex rectal fistula with abscess formation is rare. Tumor necrosis factor antagonists combined with percutaneous drainage or surgical intervention is optimal treatment for fistulizing CD with intraabdominal abscess. There is no study show the efficacy of vedolizumab in such complicated condition. Case summary A 47-year-old man has decompensated liver cirrhosis, child B. He suffered from abdominal pain, bloody diarrhea, fever, and body weight loss. CD with rectoprostatic fistula, rectopresacral fistula, pre-sacral abscess and cyto-megalovirus (CMV) infection were noted. He received antibiotics, anti-viral therapy, transverse colostomy and vedolizumab treatment. Six months later, he had deep remission and complete fistula tracts closure. Conclusion Early vedolizumab and stool diversion are effective and safe in treating CD with complex rectal fistula with abscess formation.
- Published
- 2021