Year 2017 / Volume 109 / Number 4
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Coloduodenal and enterocutaneous fistula in twins with Crohn´s disease

291

María Pilar Ballester, David Martí, Marta Maia Boscá Watts, José Martín Arévalo, Miguel Mínguez,

Abstract
We present the case of a pair of 45-year-old monozygotic twins (A and B) diagnosed with Crohn's disease (CD) at age 20 (A) and 22 (B) with similar presenting symptoms: diarrhea, fever and weight loss. Both of them had duodenal and ileocolonic disease (A2, L3+L4 according to Montreal classification); twin B also presented jejunal involvement and perianal disease (B1p). They received treatment with antibiotics, corticosteroids, 5-ASA, azathioprine and anti-TNF with a poor control of activity. They both developed a coloduodenal fistula that required surgery. Twin A developed the fistula 12 years after the first presentation; fistula closure with duodenorraphy and ileocolonic resection with gastrojejunostomy was performed. Twin B developed the fistula 22 years after the first presentation, and right colectomy, partial duodenectomy and duodenorraphy was carried out. Both developed an enterocutaneous fistula during the postoperative period. With intensive medical treatment, both twins remain asymptomatic.
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References
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Ballester M, Martí D, Boscá Watts M, Martín Arévalo J, Mínguez M. Coloduodenal and enterocutaneous fistula in twins with Crohn´s disease. 4208/2016


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Publication history

Received: 18/01/2016

Accepted: 26/08/2016

Published: 31/03/2017

Article revision time: 205 days

Article editing time: 438 days


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