Successful Fistula Closure After Treatment with Colostomy and Infliximab in a Patient with Ulcerative Colitis Complicated by Rectovaginal Fistula.

IF 5.3 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Biologics : Targets & Therapy Pub Date : 2024-05-06 eCollection Date: 2024-01-01 DOI:10.2147/BTT.S457300
Sota Katsube, Satohiro Matsumoto, Masahiro Misawa, Nao Kakizawa, Ryo Hashimoto, Taku Mizutani, Keita Matsumoto, Shuhei Yoshikawa, Hirosato Mashima
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Abstract

The patient was a 50-year-old Japanese woman who was diagnosed with total-colitis-type ulcerative colitis (UC) at the age of 26 years. She was treated with mesalazine and azathioprine, and her disease activity was well controlled. At the age of 50 years, the patient was experiencing fever, abdominal pain, diarrhea, bloody stool, and anal pain, which led to a diagnosis of a relapse of UC. Although steroid therapy was administered and tended to improve her symptoms, fecaloid vaginal discharge occurred, and rectovaginal fistula (RVF) was confirmed. Colostomy was performed, and infliximab was initiated as maintenance therapy for UC. All symptoms improved, and RVF closure was confirmed 6 months after the initiation of infliximab. To date, she has been free from relapse of UC. There have been only a few reports of UC complicated by RVF, and this condition is often difficult to treat. To the best of our knowledge, no other case of UC complicated by RVF in which the fistula was closed after treatment with colostomy and infliximab has been previously reported; thus, our report of the present case is valuable to the literature.

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直肠阴道瘘并发溃疡性结肠炎患者接受结肠造口术和英夫利昔单抗治疗后成功关闭瘘管
患者是一名 50 岁的日本女性,26 岁时被诊断出患有全结肠炎型溃疡性结肠炎(UC)。她接受了美沙拉嗪和硫唑嘌呤治疗,疾病活动得到了很好的控制。50 岁时,患者出现发热、腹痛、腹泻、血便和肛门疼痛,因此被诊断为 UC 复发。虽然进行了类固醇治疗,症状有所改善,但还是出现了粪便样阴道分泌物,并确诊为直肠阴道瘘(RVF)。患者接受了结肠造口术,并开始使用英夫利西单抗作为 UC 的维持治疗。所有症状均有所改善,在开始使用英夫利昔单抗 6 个月后,确认直肠阴道瘘闭合。迄今为止,她的 UC 一直没有复发。目前只有少数 UC 并发 RVF 的报道,而且这种情况通常很难治疗。据我们所知,此前还没有其他病例在接受结肠造口术和英夫利昔单抗治疗后瘘管闭合的病例;因此,我们对本例病例的报告在文献中具有重要价值。
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来源期刊
Biologics : Targets & Therapy
Biologics : Targets & Therapy MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
8.30
自引率
0.00%
发文量
22
审稿时长
16 weeks
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