Digestive Diseases and Sciences

, Volume 64, Issue 12, pp 3446–3450 | Cite as

It’s What’s Up Front That Counts—Part Two: Esophageal Crohn’s Disease Complicated by Recurrent Upper Gastrointestinal Bleeding

  • Alexander N. Levy
  • Naiim Ali
  • Juliana Andrici
  • Matthew J. HamiltonEmail author
Multicenter Seminars: IBD (MUSE: IBD)

Case Presentation

Background Data

A 49-year-old woman with stricturing and penetrating ileocolonic Crohn’s disease (CD) complicated by rectosigmoid and anal strictures, perianal fistula, as well as recurring rectovaginal fistula was evaluated for complaints of mild esophageal dysphagia.

The patient was initially diagnosed with CD at age 29 when she developed diarrhea and a perianal fistula. Following loss of response to azathioprine and mesalamine, standard dose infliximab was initiated in 2006. Shortly thereafter, she was diagnosed with a rectovaginal fistula in the setting of passing gas and small amounts of stool through her vagina after which the infliximab dose was optimized. She underwent three balloon dilations for a tight rectal stricture but remained otherwise clinically well until 2011 when her rectovaginal fistula returned subsequent to delivering a healthy child via cæsarean section. Although colorectal surgery was consulted, they deferred advancement flap surgery due to...



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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Alexander N. Levy
    • 1
  • Naiim Ali
    • 2
  • Juliana Andrici
    • 3
  • Matthew J. Hamilton
    • 1
    Email author
  1. 1.Crohn’s and Colitis CenterBrigham and Women’s HospitalBostonUSA
  2. 2.Department of RadiologyBrigham and Women’s HospitalBostonUSA
  3. 3.Department of PathologyBrigham and Women’s HospitalBostonUSA

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