04 September 2023
: Case report 
Gastric and Duodenal Fistulas in Crohn’s Disease, a Surgical Challenge: Report of 5 Cases and a Review of the Literature
Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Carlos Walter Sobrado Junior
1ABCDEF*, Helder De Moura Villela Junior1BCEF, Carolina Bortolozzo Graciolli Facanali1EF, Lucas Faraco Sobrado1BDF, Mariane Gouveia Monteiro de Camargo1DE, Sergio Carlos Nahas 1AE
DOI: 10.12659/AJCR.940644
Am J Case Rep 2023; 24:e940644
Table 1. Clinical features of patients with gastric and duodenal fistulas in Crohn’s disease.
| Site of origin | Time of onset of symptoms (months) | Change in albumin level | Change in CRP level | Diagnosis | Preoperative optimization | Postoperative hospital stay (days) | Postoperative prophylaxis therapy | Time of followup | |
|---|---|---|---|---|---|---|---|---|---|
| Case 1 | Ileum | 4 | 1.6 to 3.6 | 57 to 14 | CT | PN + antibiotics | 9 | Adalimumab | 7 years |
| Case 2 | Transverse colon | 1 | 2.3 to 4.8 | 47 to 3.9 | Intra-operative | PN + antibiotics | 15 | Infliximab | 8 years |
| Case 3 | Ileocolic anastomosis | 12 | 1.9 to 2.2 | 163.6 to 86.4 | CT | EN and PN + antibiotics | 17 | Adalimumab | 9 months |
| Case 4 | Ileocolic anastomosis | 9 | 2.3 to 3.4 | 21.7 to 8.5 | CT + DUE | EN and PN + antibiotics | 21 | Infliximab + Azathioprine Since 2021 started Ustekinumab | 14 years |
| Case 5 | Transverse colon | 3 | 2 to 3.7 | 85.2 to 8.8 | CT + DUE | EN + antibiotics | 7 | Certolizumab + Azathioprine | 3 years |
| CT – computed tomography; DUE – digestive upper endoscopy; CRP – C-reactive protein; PN – parenteral nutrition; EN – enteral nutrition. CRP reference value 3.5 g/dL. | |||||||||