Management of urinary complications in Crohn's disease

Citation
S. Sato et al., Management of urinary complications in Crohn's disease, SURG TODAY, 29(8), 1999, pp. 713-717
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY
ISSN journal
0941-1291 → ACNP
Volume
29
Issue
8
Year of publication
1999
Pages
713 - 717
Database
ISI
SICI code
0941-1291(1999)29:8<713:MOUCIC>2.0.ZU;2-H
Abstract
Among the 127 patients who underwent surgical treatment for Crohn's disease at Tohoku University Hospital, urinary complications were noted in 13 pati ents (10.2%), including urolithiasis in 6 patients (4.7%), a ureteral obstr uction in 4 (3.1%), and urinary fistula in 3 (2.4%). In patients with uroli thiasis, conservative therapy was effective, An ureteral obstruction was de tected on the right side in all 4 of these cases because of the inflamed te rminal ileum, In 2 of the 4 cases, the symptoms improved by either preopera tive total parenteral nutrition or elemental diet therapy. A resection of t he inflamed intestine was necessary in all cases. In patients with urinary fistulas, a resection of the inflamed intestine combined with a reconstruct ion of the urinary tract was carried out after total parenteral nutrition. In conclusion, conservative therapy with preoperative total parenteral nutr ition or elemental diet therapy proved to be effective for a ureteral obstr uction since it improved the intestinal inflammation. As a definitive treat ment, surgery is still necessary for the management of urinary fistulas and ureteral obstruction. Based on our findings, patients,vith urolithiasis in Crohn's disease should thus be treated conservatively in the same way as p atients without Crohn's disease.