Crohn’s Disease In Fallopian Tube – Rare But Complicated

Crohn’s disease in fallopian tube is one of the rarer complications of the disease. It is so uncommon that only a few known cases have been recorded and all cases were discovered, while the patient was undergoing surgery due to other complications of Crohn's disease. Enterosalpingeal fistula, as it is called, required the removal of the infected bowel and the fallopian tube that was affected.

Crohn's disease is the inflammation of the GI tract that occurs due to the malfunctioning of the Immune system. The inflammation may occur in different places in different patients, but mostly occurs in the small intestines. The disease is known to cause bowel inflammation and fistulas or strictures. Fistulas may include other parts of the body such as, the stomach, bowels, bladder, and colon, and in rarer cases the reproductive organs such as the ovaries, vagina, and fallopian tubules. Crohn’s disease in fallopian tube occurs, when the terminal ileum fistulizes or forms a fistula with the fallopian tubule.

 

Patients, who have Crohn’s disease in fallopian tube, rarely are aware that it has affected their reproductive organs. Amy, a 26-year-old woman, who had not yet married or had children, had a sudden onset of severe abdominal cramping, nausea, vomiting, diarrhea, and was hospitalized. She experienced tenderness and palpitation in the right lower quadrant of her body. Colonoscopy revealed that she had ileal-rectal fistula, as well as several multiple fistulas that were highly inflamed and that required a surgery. It was while she was being operated that her physicians discovered a pelvic mass comprising of her bladder, terminal ileum, and the right fallopian tube. Examination revealed that both ovaries and the left fallopian tube were unaffected and were left untouched. The surgeons carefully removed the infected parts [including the right fallopian tube] and closed the fistula successfully.

 

It is to be noted that the patient had been carefully examined and yet, the doctors had not been able to identify her problem as a complication such as Crohn’s disease in fallopian tube. They discovered the Enterosalpingeal fistula, while taking corrective action to close other fistulas.

 

In some cases, women who report pelvic pain may have granulomatous lesions in the fallopian tube and ovaries, as another complication of the disease. The patient may have an Adnexal mass that may have to be removed, which may also cause infertility. This may have a serious psychological impact on the patients. Patients can start feeling depressed, think less of themselves, and it may affect their sex life and feel socially alienated. It is helped, if the physicians can gain the confidence of their patients and help instruct the family of the patient regarding her care and how to cope with her rising psychological insecurities.

 

The psychological aspect of the disease has to be addressed, as women will already be weak and worn out, as their digestive system has been impaired. This can result in malnutrition, as the body cannot absorb the nutrients and because diarrhea is another symptom that can worsen the physical and psychological condition of the patient. The fact that they may become infertile has to be addressed in a sensitive manner. This can be tough, as the patients in may include unmarried women of childbearing age.

 

When women appear to have gynecological complications or suffer from pelvic/abdominal pain, have ulcerative lesions in their vagina, may have a chance of being a victim of Crohn’s disease in fallopian tube.