Laparoscopic management of Crohn's disease-related complex enterovesical, enterocutaneous and enteroenteric fistula: A case report.

The management of Crohn's disease is medical, with surgery reserved for emergencies and complications. Fistulizing Crohn's disease can present with either an internal or external fistula. Internal fistulae are common in patients with ileocolonic disease. Enterovesical fistulae form a very small part of these internal fistulae. An ileovesical fistula with other concomitant internal or external fistulae is a complex fistula. A patient with an ileovesical fistula further compounded by an enteroenteric fistula and an enterocutaneous fistula is a difficult surgical patient to manage because of the resultant dense inflammation. Here we report a case of complex ileovesical fistula (concomitant enterocutaneous fistula and enteroenteric fistula) managed by a laparoscopic approach.