Crohn’s Disease and Urinary Manifestations: A Crohn’s Intestinal Disease Mimicking a Bladder Mass

Bronislava Papadatou, Lidia Monti, Giuliano Torre, Fabio Panetta, Antonella Diamanti

Department of Radiology, “Bambino Gesù” Children’s Hospital, Rome, Italy.
Gastroenterology, Hepathology and Nutrition Unit, “Bambino Gesù” Children’s Hospital, Rome, Italy.

DOI: 10.4236/health.2014.612182                

Abstract

We report a rare mode of presentation of Crohn’s Disease (CD) in a 17-year-old boy, who was admitted at our hospital due to abdominal pain, dysuria, polyuria and fever. The ultrasound showed an increased wall thickness of the small bowel and cecum and a vegetating lesion adjoined into the bladder. The histology was not suggestive of CD and it excluded the bladder neoplasm. Based on the biochemical assessment and the imaging, we started the treatment specific for CD (nutritional therapy by Modulen, short courses of steroids, azathioprine and mesalazine during the follow up), These treatments improved the gastrointestinal symptoms and the nutritional status of our patient but also induced the disappearance of the mass adjoined into the bladder. In spite of the severe onset, in this patient, the clinical course of CD was mild and responder to conventional therapy.

Keywords

Crohn’s Disease, Bladder Mass, Adolescents

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Loftus Jr., E.V. (2004) Clinical Epidemiology of Inflammatory Bowel Disease: Incidence, Prevalence, and Environmental Influences. Gastroenterology, 126, 1504-1517. http://dx.doi.org/10.1053/j.gastro.2004.01.063
[2]	Cummings, J.R., Keshav, S. and Travis, S.P. (2008) Medical Management of Crohn’s Disease. BMJ, 336, 1062-1066. http://dx.doi.org/10.1136/bmj.39547.603218.AE
[3]	Pardi, D.S., Tremaine, W.J., Sandborn, W.J., et al. (1998) Renal and Urologic Complications of Inflammatory Bowel Disease. The American Journal of Gastroenterology, 93, 504-514. http://dx.doi.org/10.1111/j.1572-0241.1998.156_b.x
[4]	Joffe, N. (1976) Roentgenologic Abnormalities of the Urinary Bladder Secondary to Crohn’s Disease. American Journal of Roentgenology, 127, 297-302. http://dx.doi.org/10.2214/ajr.127.2.297
[5]	Merine, D., Fishman, E.K. and Huhlman, J.E. (1989) Bladder Involvement in Crohn’s Disease: Role of CT in Detection and Evaluation. Journal of Computer Assisted Tomography, 13, 90-93. http://dx.doi.org/10.1097/00004728-198901000-00019
[6]	Molnár, T., Tiszlavicz, L., Balogh, D.A., et al. (2000) Crohn’s Disease of the Bladder. A New Type of Metastatic Granulomatous Inflammatory Disease? The American Journal of Gastroenterology, 95, 850-851.
[7]	Fujimura, S.K.Y., Kihara, T., Uchida, J., et al. (1992) Transitional Cell Carcinoma of the Bladder Associated with Crohn’s Disease: Case Report and Review of the Literature. The British Journal of Radiology, 65, 1040-1042. http://dx.doi.org/10.1259/0007-1285-65-779-1040
[8]	Juan, C., Patron, U.M., Khurrum, B.J.J., et al. (2003) An Unusual Way to Diagnose a Rare Case of Bladder Carcinoma in a Patient with Crohn’s Disease. International Journal of Colorectal Disease, 18, 172-173.
[9]	Evans, C.E. and Tighe, M.P. (2014) Crohn’s Disease Presenting as Bladder Mass. Archives of Disease in Childhood, 99, 256. http://dx.doi.org/10.1136/archdischild-2013-305500