Contemporary surgical management for ileosigmoid fistulas in crohn's disease

Genevieve B. Melton, Luca Stocchi, Elizabeth C. Wick, Kweku A. Appau, Victor W. Fazio

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Background: Current diagnostic modalities and surgical treatments for ileosigmoid fistulas (ISF) in Crohn's disease (CD) are not well characterized. Methods: ISF patients operated during 2000-2007 in a prospectively collected CD surgery database were included. Disease extent, diagnostic studies, medications, and smoking status were retrospectively reviewed. Results: One hundred four CD patients with ISF (median age 37) underwent ileocolic resection (75 open, 29 laparoscopic). Sigmoid colon was treated with primary repair (26), segmental resection (71), and subtotal colectomy (7). Thirty-eight patients required additional surgery for CD manifestations (ileovesical fistula (11), enterocutaneous fistula (11), and synchronous small bowel disease (22)). Overall sensitivity of studies for ISF detection was 63% (66/104) (colonoscopy 35% (31/89), CT scan 41% (31/76), fluoroscopy 53% (31/58)). Stoma diversion (53 patients, 51%) occurred more with open surgery (81% vs. 63%, p∈=∈0.04), intraoperative ureteral stents (28% vs. 2%, p∈

Original languageEnglish (US)
Pages (from-to)839-845
Number of pages7
JournalJournal of Gastrointestinal Surgery
Issue number5
StatePublished - May 2009
Externally publishedYes


  • Crohn's disease
  • Ileal disease
  • Intestinal fistula
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology


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