Biologics: Targets & Therapy (May 2024)

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

  • Katsube S,
  • Matsumoto S,
  • Misawa M,
  • Kakizawa N,
  • Hashimoto R,
  • Mizutani T,
  • Matsumoto K,
  • Yoshikawa S,
  • Mashima H

Journal volume & issue
Vol. Volume 18
pp. 107 – 113

Abstract

Read online

Sota Katsube,1 Satohiro Matsumoto,1 Masahiro Misawa,2 Nao Kakizawa,3 Ryo Hashimoto,1 Taku Mizutani,1 Keita Matsumoto,1 Shuhei Yoshikawa,1 Hirosato Mashima1 1Department of Gastroenterology, Jichi Medical University Saitama Medical Center, Saitama, Japan; 2Department of Obstetrics and Gynecology, Jichi Medical University Saitama Medical Center, Saitama, Japan; 3Department of General and Gastrointestinal Surgery, Jichi Medical University Saitama Medical Center, Saitama, JapanCorrespondence: Sota Katsube, Department of Gastroenterology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma, Saitama, Omiya, 330-8503, Japan, Tel +81 48 647 2111, Fax +81 48 648 5188, Email [email protected]: 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.Keywords: ulcerative colitis, rectovaginal fistula, infliximab, colostomy

Keywords