Complicated Cases in GI

Anthony Kalloo, MD; Jonathan M. Buscaglia, MD

Chapter 17: A 58-Year-Old Womanwith Fistulizing Crohn’S Disease (continued)

John Clarke, MD

A 58-year-old woman with a 35-year history of Crohn’s disease presented with copious amounts of stool draining from her vagina. In general, she reported a gradual clinical decline over 2 years characterized by weight loss (25 lbs), malaise, fatigue, abdominal discomfort, and nausea. She required frequent use of diapers over the previous year for large amounts of feculent vaginal discharge. She denied GI bleeding, fevers, arthritic complaints, and dermatologic changes. Two years prior to presentation, her history of fistulizing Crohn’s disease was complicated by a sigmoid colonic…